Failed TVT Surgery - What Can Be Done?5th Mar 2018
Many women experience some degree of urinary incontinence after childbirth, though this can also develop later in life as we age. There are many treatments available, from behaviour therapies and medication through to surgery.
One such type of surgery uses a mesh patch or a vaginal tape, also known as TVT, TVTO and TOT, which is placed under the urethra like a sling or hammock to keep it in its normal position and prevent incontinence. A similar procedure can also be used to treat hernias, prolapse, and bladder and bowel disorders.
However, recent media attention has brought to light the number of these operations that have resulted in life-altering complications. While many women’s operations have successfully treated their issues and they experience no difficulties afterwards, a significant number suffer from chronic, debilitating pain and other side effects.
This has become an international scandal over the last couple of years as more and more women have learned that they were not alone in their mistreatment and subsequent suffering. The practise has now been banned in several countries and by several NHS Trusts in the UK.
Whilst the NHS and Medicines and Healthcare products Regulatory Agency (MHRA) in the UK warn of just a 1-3% chance of complications, recent research by the US Food and Drugs Administration has revealed that the trocar hooks used to implant the mesh cause injuries for up to 39% of women having a prolapse mesh and 29% of women having a mesh inserted for incontinence.
How will I know if I’ve developed a problem with my mesh?
If your operation has immediately failed, or if you develop complications years down the line, it’s likely that you will be aware of an issue straight away because of the often severe pain associated with the problem.
There most common symptoms which could indicate your mesh implant may have failed are:
- Pain in the vagina or bladder, usually caused by nerve damage
- Pain during intercourse, from either yourself or your partner
- Pain in the thighs which can cause mobility difficulties
- Discharge or bleeding from the vagina
- Frequent urinary tract infections (interstitial cystitis)
- Urinating very frequently
- Needing to urinate very urgently (new onset urgency)
- Inability to urinate
These problems could be caused by:
- The tape eroding into the vagina (erosion is the most common issue associated with this surgery, which occurs in around 10% of patients)
- The tape eroding into the urethra
- The tape being incorrectly placed/inserted
- An infection
- Nerve damage
If you are suffering from any of these symptoms following your mesh operation – or even years down the line, as complications can unfortunately develop at any time – then you should see your GP immediately. It’s likely that they will refer you to a specialist.
Your specialist will:
- Examine you and explain the cause/diagnosis – this sometimes erosion cannot be determined by physical examination alone, so you may need to see a urologist who will look inside your bladder
- Explain the treatment required
- Report the complication to the relevant authority (this is the MHRA in the UK)
- Tell you whether the problem has been caused by the mesh being inserted incorrectly
What can be done if I have a problem with my mesh?
Depending on the cause and severity of your problem, there are several treatments available:
- Removal of the mesh – unfortunately, as mesh was not designed to be removed but to be a permanent fixture, this procedure can be very difficult
- Partial removal of the mesh – if full removal is too risky, or if the part of the mesh which is causing the problem can be easily identified and extracted
- Physical therapy – to help manage the pain
- Medical therapy – such as oestrogen cream which can help to rebuild the vaginal wall and treat minor cases of erosion
It goes without saying that if you are still suffering, or are not happy with the recommended course of action, you should always seek a second opinion, or request to be seen by another consultant or at another hospital.
Can I make a complaint?
If you are not satisfied with the advice you were given, believe you did not give informed consent when you agreed to the operation, or are suffering because of the treatment you received, then you should make a complaint to the NHS or the private medical facility where you had your operation.
If you're thinking of making a complaint, someone from the independent NHS Complaints Advocacy Service can help you. An advocate can attend meetings with you and review any information you're given during the complaints process. Your local council can tell you who the advocacy provider is in your area.
You can either complain to the NHS service provider directly – such as the hospital where you received your treatment – or to the commissioner of the services (the body that pays for the NHS services you use) but you cannot make a complaint to both.
Though you won’t receive any compensation by going through the NHS complaints procedure, it can be a good idea if you are considering taking legal action. The complaint will be investigated and you will be given a full report which can prove useful to your case as it will often give you – and your solicitor – more information regarding what went wrong.
Can I claim compensation?
If you’re suffering since your surgery and have been informed by a surgeon that your TVT mesh was incorrectly inserted, you may able to claim compensation in order to help rebuild your life. You must start your legal claim within 3 years from when the incident happened, or when you first realised you’d suffered an injury.
Coles Miller partner and Lydia Barnett is a specialist TVT claims solicitor. She always deals with cases personally and always with the utmost compassion and sensitivity.
Lydia answers some frequently asked questions in this video.
To start your claim, or book a free initial chat, get in touch and Lydia will call you back at a time that suits you.