TVM MESH CLINICS

 

The beginning of the healing journey for a mesh injured woman, needs to reflect a deep compassionate understanding of where she has come from and that she needs help.

 

Since the 2017 Senate Inquiry into Number of women who have had transvaginal mesh implants and related matters the Federal Government mandated all major hospitals in all states were to offer services to women adversely affected by TVM.  Few hospitals have created what a mesh injured person would need, some have, with the assistance of mesh injured consumers (see the list below).

The following information was created by the former charity MIA (Mesh Injured Australia Inc.) and serves as a guideline for the standard of service a mesh injured person should receive and expect:-

Goals

  • Create a safe space for mesh injured women.
  • Help and support women emotionally and practically.
  • Re-establish mesh injured women’s faith in the medical system.
  • Offer a high standard of transparent care at all times.
  • Care is to be tailored to the individual needs of each woman.
  • Develop a consistent programme to be replicated in each State/Territory across Australia.
  • Acknowledge the many losses associated with mesh injury – health & wellbeing, partners & family members, jobs and careers, the financial hardship suffered, loss of sanity and the need to find some peace and acceptance.

Intake

In order to engage women, trauma trained counsellors/social workers need to do intake, preferably in the home of a woman to capture an understanding of her life and to reduce the trauma associated with attending medical appointments and hospitals and allow space for a woman to “tell her story” via telephone or telehealth. N.B. Some mesh injured women are housebound.

All Clinics require the following:

  • Need to be multidisciplinary in their approach. (see diagram)

  • Medicare funded.
  • A 1 “stop shop”. Able to provide multiple appointments (same day) for women who have to travel to attend the clinic.
  • A support person (Intake person preferably for continuity of care and support) to attend all appointments within the clinic if required – desired.
  • Be transparent in their skill set & experience  (refer interstate if necessary – e.g. Canberra refers to Sydney for removal surgery).
  • Accept interstate patients and source/provide funding for travel and accommodation to enable a woman’s choice of treatment.

Services

  • 3D4D ultrasound diagnostics to be performed in real time with treating specialist present.
  • Continence aids, prescriptions & mobility and assistance aids supplied & funded.
  • Mesh alternatives available (pessary, Botox etc.).
  • Pain management services.
  • Native tissue repair surgery available post removal.
  • Interstate travel funding – patient assisted transport provided prior to attendance.

Clinicians

ALL health care professionals require the following:

  • A broad understanding of the history of mesh and its overuse.
  • To have listened to multiple women’s stories to understand the complexity and variety of issues suffered by mesh injured women.
  • Have attended trauma training to support their work and their mesh injured patients. (NOT just 1 day workshops)
  • Commit to working with an open and inquisitive mind and be willing to work collaboratively with Doctors internationally.
  • A willingness to listen and hear every woman’s concerns for her health and treat them accordingly.
  • Commit to reading a patient’s file in full, prior to their appointment.
  • Show willingness to acknowledge each woman attending the clinic is experiencing multiple devastating complications as a result of mesh.

Post-Removal of Mesh

  • Continence nurses to keep in daily contact with women post-surgery for as long as necessary.

  • Removal surgeons to be “on call” & available post-surgery for women’s needs & for any complications that may arise.

  • Rehabilitation therapy post-surgery for as long as necessary.

  • Access to psychological support as and when required.

  • Follow up until end of life for those that require lifelong care due to their sustained injuries.

Long Term Commitment to Mesh Injured Women

  • Intensive and consistent follow up for women needing life-long care.

  • Commitment to support change in medical system to avoid a disaster like this one ever happening again.

  • Support to rebuild their lives or manage their outcomes effectively.

  • Intensive and long-term psychological support in the forms of talk therapy, support group facilitation, residential treatment programmes (Quest For Life) available.

  • Simplifying the administrative & complaints process and ensure consumer co-design in all mesh injured services.

These clinics have had consumer co-design with mesh injured women:-

Queensland – Queensland Pelvic Mesh Clinic

Queensland have had a functioning clinic since April 2019, it has been co-designed with mesh injured women and located on the Gold Coast.

NSW – RPA Mesh Clinic

New South Wales (Sydney) has the Royal Prince Alfred (RPAH) hospital in Sydney, this has also been co-designed with mesh injured women (including the author).

South Australia – SA Pelvic Mesh Clinic

SA Health has established a dedicated Pelvic Mesh Clinic at the Royal Adelaide Hospital, this has had a degree of consumer co-design.