NICE to ban mesh for vaginal wall prolapse

Transvaginal mesh should not be used to treat vaginal wall prolapse, because of “serious but well recognised safety concerns,” says draft procedural guidance from the UK National Institute for Health and Care Excellence seen by The BMJ.

The guidance from NICE’s Interventional Procedure Advisory Committee, due to be published on 20 December, concluded that transvaginal mesh repair of anterior or posterior vaginal wall prolapse should be used only in the context of research. NICE said that its guidance had not yet been officially released and was subject to change.

The draft procedural guidance said that data from randomised controlled trials showed no added benefit of using mesh over native tissue repair. It added that when complications occurred these could be serious and have life changing consequences. Evidence of long term effectiveness was inadequate in quality and quantity, it said. Further research was needed, it concluded, which should include details of selection of patients, long term outcomes, including complications, the type of mesh used and method of fixation, and measures of quality …