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U.K.’s Health Watchdog Recommends Ban on Transvaginal Mesh


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The U.K.’s National Institute for Health and Care Excellence has recommended a ban on transvaginal mesh for pelvic organ prolapse, according to guidance released Friday.

“The evidence for long term efficacy is inadequate in quality and quantity,” the health watchdog said in its official guidance. “Therefore, the procedure should only be used in the context of research.”

In its decision, the agency also weighed the concern over device complications voiced by patients and patient groups.

The National Health Service — England’s national health care system — does not have to act on recommendations, but experts say the recommendations will result in a de facto ban.

“The recommendations by [the National Institute for Health and Care Excellence] are highly significant, as I think they will make us all re-evaluate the way we use mesh,” mesh expert and former National Institute board member Dr. Sohier Elneil told U.K.’s Sky News.

In the U.K., about 14,500 women undergo mesh surgery to treat incontinence or pelvic organ prolapse, according to a 2012 Department of Health report.

That number is 38 times greater in the U.S., where 100,000 women undergo prolapse surgeries with mesh and 208,000 women undergo incontinence surgeries transvaginally with mesh, according to the FDA’s latest available figures.

So far, the U.S. Food and Drug Administration has not considered a ban in the U.S. nor has it commented on transvaginal mesh bans in other countries.

Mesh Patient Advocate: U.K. Ban Doesn’t Go Far Enough

The U.K. agency’s recommendation follows recent bans on pelvic mesh in Australia and New Zealand.

Like Australia’s ban, the U.K.’s proposed ban focuses on mesh used to treat pelvic organ prolapse. That leaves mesh used to treat stress urinary incontinence on the market.

About 13,000 U.K. mesh surgeries a year apply to incontinence while only 1,500 are for prolapse, the U.K.’s Department of Health revealed in its 2012 report.

Injured by complications related to transvaginal mesh? Get a Free Case Review

The founder of Sling the Mesh, a U.K. advocacy group for mesh-injured people, told the press the ban does not go far enough.

“By restricting the use of vaginal prolapse mesh to research only, it’s effectively a backdoor ban,” Kath Sansom told U.K.’s Sky News. “But it needs to go further to include the hundreds of women who suffer every day from mesh used to treat stress incontinence. They need to be taken seriously.”

New Zealand announced earlier this week that it would ban mesh for all urogynecological uses, including incontinence. It is the first country to announce a total ban on transvaginal mesh.

“As a consequence of the Australian [Therapeutic Goods Administration] review of surgical mesh for urogynaecological use, and subsequent regulatory action, there is a case for Medsafe to question the safety of certain devices,” Medsafe, New Zealand’s heath agency, said.

BBC Panorama: Manufacturers Failed to Warn Doctors

Controversy surrounding transvaginal mesh implants increased this week after a recent BBC Panorama investigation revealed Johnson & Johnson’s Ethicon — one of the largest manufacturers of mesh — did not properly warn doctors about the risks of transvaginal mesh.

BBC Panorama’s investigation put a spotlight on conflicts of interest, weak clinical trials and a poor regulatory system for vaginal mesh in the U.K. The report aired just days before the announcement of the U.K. ban recommendation.

Ethicon, the maker of Gynecare TVT mesh (sold in the U.K. and the U.S.), did not properly inform doctors of the risks, according to BBC Panorama.

The company admitted it did not update its instructions for use for three Gynecare TVT implants with risk data until 2015. Still, the 2015 instructions contain insufficient risk data, Panorama found.

“I would expect the manufacturer to have a comprehensive list of the adverse events and the risks within the [instructions for use] so I fully understand these and communicate them,” urogynecologist Wael Agur told Panorama.

The investigation also revealed Ethicon tested one device, the TVT-Secur implant, only in sheep and 31 women for five weeks before selling it in 2006. The company pulled it from the market in 2012.

The J&J subsidiary is one of several mesh manufacturers facing lawsuits in several countries over allegations that transvaginal mesh implants are defective in design and caused serious complications, such as pelvic pain and organ damage. This includes about 28,000 federal cases in the U.S.

Michelle Llamas, Senior Content Writer
Written By Michelle Llamas Senior Writer

Michelle Llamas has been writing articles and producing podcasts about drugs, medical devices and the FDA for nearly a decade. She focuses on various medical conditions, health policy, COVID-19, LGBTQ health, mental health and women’s health issues. Michelle collaborates with experts, including board-certified doctors, patients and advocates, to provide trusted health information to the public. Some of her qualifications include:

  • Member of American Medical Writers Association (AMWA) and former Engage Committee and Membership Committee member
  • Centers for Disease Control and Prevention (CDC) Health Literacy certificates
  • Original works published or cited in The Lancet, British Journal of Clinical Pharmacology and the Journal for Palliative Medicine
Edited By
Emily Miller
Emily Miller Managing Editor

8 Cited Research Articles writers follow rigorous sourcing guidelines and cite only trustworthy sources of information, including peer-reviewed journals, court records, academic organizations, highly regarded nonprofit organizations, government reports and interviews with qualified experts. Review our editorial policy to learn more about our process for producing accurate, current and balanced content.

  1. (2011, July). Urogynecologic Surgical Mesh: Update on the Safety and Effectiveness of Transvaginal Placement for Pelvic Organ Prolapse. Retrieved from
  2. National Institute for Health Care and Excellence. (2017, December 15). Mesh for vaginal wall prolapse should only be used in the context of research, says NICE. Retrieved from
  3. National Institute for Health Care and Excellence. (2017, December 15). Transvaginal mesh repair of anterior or posterior vaginal wall prolapse. Retrieved from
  4. Marsden, H. (2017, December 11). Panorama Investigation reveals medical company failed to fully inform doctors of vaginal mesh risks. Retrieved from
  5. Department of Health. (2012, November 22). Better guidance and support for NHS surgeons on vaginal tape and mesh implants. Retrieved from
  6. Lomas, C. (2017, December 12). New Zealand bans vaginal mesh over safety fears. Retrieved from
  7. Lomas, C. (2017, December 15). Vaginal mesh use should be restricted to research only, says health watchdog. Retrieved from
  8. Medsafe. (2017, December 11). Medsafe introduces surgical mesh restrictions. Retrieved from
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