Urologists support New Zealand MOH report recommendations on surgical mesh

The Urological Society of Australia and New Zealand (USANZ) supports recommendations in the Hearing and Responding to Stories of Survivors of Surgical Mesh report released today by the New Zealand Ministry of Health in response to complications resulting from the use of surgical mesh in a range of operations, including for stress incontinence and pelvic organ prolapse.

The Ministry of Health commissioned the review, in which New Zealand urologists participated alongside a wide range of consumer and other health groups, to provide a plan “to minimize future risk to consumers and support those harmed by it”.

“The Urological Society of Australia and New Zealand (USANZ) congratulates the Ministry of Health for this collaborative and constructive approach,” said USANZ President, Dr Stephen Mark.

“We would like to acknowledge the men and women who were brave enough to share their story, we know that this would have been extremely difficult,” said Dr Mark.

“The Urological Society acknowledges that complications from the use of mesh for treating stress urinary incontinence and pelvic organ prolapse has caused considerable physical and psychological harm in some patients, which we feel is unacceptable.

“We also acknowledge and accept findings that there were deficiencies in technical and communication skills of some surgeons. We recognise the distress caused to these patients and want to be part of the solution in helping these people, as well as ensuring no patients are harmed in future,” said Dr Mark.

“Further research is necessary to achieve best practice outcomes and help us understand why, when, and in which patient complications may occur. For this reason, USANZ supports participation with Australia in a mesh registry. By collaborating with Australian researchers, we can be part of a substantial database that would underpin ongoing research in the interests of patient safety.

“The establishment of specialist, multidisciplinary centres that would handle mesh surgical complications; alongside the development of a national framework for specialist credentialing is of upmost importance. The USANZ believes that a comprehensive credentialing national framework for surgeons, for mesh insertion and removal, needs to be implemented with urgency.

“Our members, lead by Dr Eva Fong, have been working with gynaecologists at Waitemata DHB to develop a specialist credentialing framework for the surgical management of stress urinary incontinence and pelvic organ prolapse. This includes the use of mesh, as well as non-mesh surgeries using native tissue, in addition to credentialing in the removal of mesh.

“We believe the robust, comprehensive credentialing model developed at Waitemata DHB by urologists and gynaecologists to manage complex mesh complications, should be supported. Funding for two additional multi specialist centres would be desirable,” said Dr Mark.

“We look forward to working with the Ministry of Health and other relevant stakeholders to improve outcomes in the use of mesh in surgery in New Zealand,” said Dr Mark.