Tension-Free Vaginal Tape and Mesh Claims

Updated 10 July 2018: NHS England has put an immediate stop on the usage of mesh to treat stress urinary incontinence. This is because of the amount of safety concerns which have been raised.

Some women have suffered serious problems after having TVT and mesh implant surgery.

Read more: Laparoscopic Ventral Mesh Rectopexy – Time to Review?

TVT and Mesh: What are they used for?

TVT and mesh are used to treat two problems women suffer after having children:
1. Urinary stress incontinence: not being able to control the bladder completely;
2. Pelvic organ prolapse: when weak muscles cause the bladder to push against the wall of the vagina.

These are quite common problems. Up to 50% of women who have had children suffer one or the other.

What is the treatment for TVT mesh problems?

There are a lot of different possible treatments for these problems. Some involve surgery, and none are perfect. Many involve quite major operations which risk damage to other organs and recovery periods are long.

A Brief History of TVT

TVT was developed during the 1990s and seemed to have many benefits. It could be done by keyhole surgery with three small holes rather than a long incision, it was easier to do, and women recovered much more quickly. Furthermore, the cure rates were good.

One of risks was that the surgeon would accidentally damage the bladder, urethra or bowel. However by 2003 a new treatment was developed: TVT-O (Obturator approach tape). This was thought to lower the risk of organ damage.

The next development was to use mesh rather than tape. These newer procedures seemed to have higher success rates. Mesh has been used more and more across the world on more than a million women.

What problems can TVT and mesh cause?

Many women had very good outcomes but some women reported complications. These included:

• Pain
• Mesh exposure or erosion: where the mesh can be seen or felt within the vagina
• Damage to the bladder, urethra or bowel
• Damage to blood vessels
• Sexual problems
• Poor bladder control – difficulty emptying the bladder, urgency, or frequency
• Infection

What do the authorities say about tvt mesh?

There has been a lot of criticism of TVT/mesh in the press and there have been successful claims against manufacturers in the USA. Generally the US authorities have been more critical than in the UK.

The MHRA (Medicines and Healthcare Products Regulatory Agency) in the UK found no evidence that vaginal mesh was unsafe if used correctly and that many women experienced long-term benefits. NICE (The National Institute for Health and Care Excellence) thought using mesh for prolapse may be better than other treatments but noted that there was a risk of significant complications. In February 2016 the Cochrane Review found that the benefit from using mesh was small and the rate of complication was higher than for other types of repair.

In the USA, the FDA (Food and Drugs Administration) has said that serious complications from synthetic mesh for pelvic organ prolapse are not rare.

I have TVT or mesh complications. Do I have a claim against my surgeon?

You may have a claim if you had:

1. Poor advice. Your surgeon should have discussed with you the different treatments and the risks and benefits of each. In particular you should have been able to consider managing your condition without surgery. You should also have been advised as to the risks of both TVT and TVT-O.

2. Poor surgery. Not every bad outcome is due to poor surgery. But there is evidence that well-trained surgeons who do many of these procedures get the best outcomes for patients. Problems from poor surgery include:
• Nerve damage (particularly to the obturator nerve in TVT-O)
• Difficulty passing urine because the tape is too tight
• Obturator tape appearing at the side of the lower vagina.

3. Delays in follow up and failures to refer problems to a specialist quickly. Where women suffer problems after surgery it is important they are treated quickly.

Some people are said to be bringing claims against manufacturers. The success of those claims is uncertain.

Learn More About TVT and Mesh Lawsuit Claims

If you would like advice about a claim, our specialist medical negligence solicitors will be happy to advise you. Get in touch and speak to us in confidence about your gynaecology negligence claim today.