Director-General of Health recommends time-limited pause on the use of female pelvic surgical mesh products to treat stress urinary incontinence

The Director-General of Health, Dr Diana Sarfati, has supported, effective 23 August 2023, a time-limited pause on the use of surgical mesh for stress urinary incontinence.

The Surgical Mesh Roundtable (MRT), an oversight and monitoring group chaired by Manatū Hauora | Ministry of Health, has been investigating a pause since earlier this year, Dr Sarfati says.

Alongside this, Parliament’s Health Committee recommended in June that Manatū Hauora investigate a pause in the procedure after it considered the petition of mesh-injured woman Sally Walker.

The MRT’s assessment is that the balance of benefit and harm from the procedure will be improved by the series of additional measures already planned, and it recommends a pause until those measures are substantively in place.

“After considering the MRT’s assessment, I have decided to support a pause to allow the following steps to be put in place to reduce the harms linked to the procedure as much as possible,” Dr Sarfati says.

Those steps are: 

• providing tailored training and certification for surgeons performing the procedure; 
• establishing a registry of all public and private patients who could benefit from it; 
• reviewing patients and the decision to carry out the procedure at multi-disciplinary meetings, which include a range of experts from physiotherapists to surgeons; and 
• using a structured and guided informed consent process for patients.

“No surgery is without risks, and it’s important to remember that this particular procedure has changed the lives of many people for the better,” Dr Sarfati says.

“However, we recognise it has caused ongoing pain and lessened the quality of life for some people, and we therefore need to act to minimise these outcomes.

“We also acknowledge the process has been slow at times and that has potentially added to the frustrations of those who have suffered harm from surgical mesh.”

Recognising the length of time to put these measures in place has been a significant factor behind our decision to put in place this time limited pause.

Dr Sarfati says, “It is important to note the procedure is paused, not banned.

“That means there may be exceptions, and that the procedure might be carried out during the pause if a multi-disciplinary team agree there is no viable alternative. Any use would only happen after extensive consultation and review.

“We acknowledge that this pause may cause additional uncertainty for patients awaiting treatment, and concern for those who have recently had it. However, we need to make sure that patients are given treatment that appropriately limits the risk of harm for as many people as possible, and we believe this move will help us achieve that.”