The reports of adverse incidents received after hernia mesh surgeries for both men and women in England and Wales has risen by 40% since 2006. From 2016 to 2017, incident reports after patients receiving surgery for a hernia repair went up by 30% alone.
Taken from an FOI request, the Communications division from the Medicines and Healthcare Product Regulatory Agency received 185 incident reports after a hernia mesh surgery between the years of 2006 to 2017.
At present, the open flat mesh repair has become one of the most popular techniques for hernia repair as it strengthens the abdominal wall without using so much tension however the surgery to implant the mesh can come with some complications.
10% of hernias come back at some point after surgery, according to NHS Choices.
The BBC article, "NHS hernia mesh repairs 'leaving patients in chronic pain'", reported that some experts are concerned about the 'thousands of hernia mesh patients who are living with chronic pain'.
General surgeon, Peter Jones, who was quoted in the BBC article spent a lot of his career removing mesh from British groin hernia patients:
"Severe pain is a common problem and patients aren't being warned about it. At least half of our patients who have a mesh repair will have a smooth recovery, but in my opinion the risks of a poor outcome are so bad. I wouldn't want to take that risk."
Some of the more common complications could require another surgery to repair what's happened or remove the mesh while the more serious complications can be life threatening.
These adverse incidents have the potential to cause unexpected or unwanted effects including the safety of patients during a medical occurrence and the data below illustrates that these adverse reports are rising.
The FOI request response saw the Customer Services of the Communications Division of The Medicines and Healthcare products Regulatory Agency saying that reported incidents may not necessarily represent an individual patient:
"Because there is no limiting time on reporting people can make multiple reports at any time after the mesh has been implanted and on the same issue.
"It should be noted that these figures include a range of recognised complications related to this type of surgical procedure and do not necessarily indicate a fault with any particular device."
The number of adverse incident reports after this specific surgery has fluctuated through out the years with it being 11 in 2006, down to 1 in 2009 and then up to 51 in 2017.
According to the NHS website, a hernia occurs when an internal part of the body pushes through a weakness in the muscle or surrounding tissue wall and usually develops between your chest and hips.
The British Hernia Centre states that one in ten people can get a hernia in their life times and it is the world most common surgical procedure with over 100,000 performed in the UK.
According to The British Hernia Centre, 1 in 10 people can get a hernia in their life times. It is the world most common surgical procedure with over 100,000 performed in the UK.
To comply with confidentiality obligations, the agency said:
"I was not able to provide data that was split up into individual years for Wales as the number of reports was low and so could indicate individual reports identifiable to specific patients or healthcare organisation's."
It isn't specifically just hernia mesh surgery which has had a range of incident reports but surgeries including mesh in general and this has spurred a regional debate over whether we should still be using mesh if there is a high chance of it causing future complications. A topic discussed on the House of Commons Hansard around Surgical mesh.
Emma Hardy, a British Labour Party politician, argues for the dis-continuation of surgical mesh:
"One of the main points I wish to make is the urgent need to suspend the use of mesh.
"The issue of surgical mesh was brought to my attention by a constituent of mine called Angie, an incredibly brave woman who used to be very fit and healthy, but who, after having incontinence following the birth of her twins and a hysterectomy, was advised to have this mesh operation.
"She is now unable to work, in constant pain and suffering, cannot take part in sports and has problems sleeping. I remember listening to what she said to me and feeling horrified that this had happened to her."
A question was asked during the proceedings of whether the most worrying thing, and part of the seriousness, is that people facing decades of pain, suffering and loss are relatively young.
Emma Hardy said:
"Surgical mesh was given to lots of young women following childbirth - many women were still in their 30s - and it has left them feeling disabled.
"The number of subsequent gynaecology out-patient appointments per 100 people having the mesh insertion procedure is 79. There are 43 out-patient appointments per 100 for rehabilitation, physiotherapy and occupational therapy. The figures show that the number of women having the procedure has fallen during the last nine years by 48%, which says an awful lot about what doctors think.
"These women were injured. These women were ignored. These women are the victims of a scandal.
"I still believe that it is an absolute scandal that these devices were aggressively marketed to doctors and then used in patients for whom they were unsuited. We need to ensure that lessons are learned and that more steps are taken to make the medical products industry more transparent.
"Campaigners have even called for legislation, such as they have in America, to require doctors to declare any grants, inducements or scholarships that they receive from the industry.
"Some patients think they are having the mesh completely removed, only to find out later that it has been only partially removed.
"They feel that they are suddenly better and that they are recovering only to go through the horror of having the symptoms come back later. It is important that, where possible, mesh should be removed in full."
Analysis conducted by Carl Heneghan, professor of evidence-based medicine at the University of Oxford and clinical adviser to the APPG on surgical mesh implants, reveals that the 100,516 women who have undergone mesh surgery in England since 2008 have required follow-up treatment in 993,035 out-patient appointments.
Professor Heneghan calculated the total cost to the NHS for all incontinence and out-patient appointments to be £245 million. His analysis of the trend in out-patient appointments also shows that more are required by women as each year passes after their surgery, which is completely the opposite of what you would expect after a successful surgery.
Since the House of Commons debate on April 19th 2018, the House commends the recent announcement to a retrospective audit into surgical mesh for pelvic organ prolapse and stress urinary incontinence.
Sheffield University has announced the development of a new mesh material and calls on the government to suspend prolapse and incontinence mesh operations while the audit is being carried out and to commit to a full public inquiry into mesh if the audit suggests that this is the best course of action.
