Patients harmed by mesh implants address emotional parliamentary meetingBMJ 2017; 358 doi: https://doi.org/10.1136/bmj.j3585 (Published 25 July 2017) Cite this as: BMJ 2017;358:j3585
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The Final Report of the "Independent Review of Transvaginal Mesh Implants" commissioned by the Scottish Government, was published on the 27 March 2017 (1). This "Final Report" is itself now under review (2) due to accusations of official interference in the process of the review and concerns raised by the petitioners and others that financial conflicts of interest in NHS Scotland may have influenced the process of "informed consent".
The "Final report" of the "Independent Review of Transvaginal Mesh Implants" was considered at an Evidence Session in the Scottish Parliament on the 18 May 2017. This was also emotionally charged. The full transcript can be read (3) and the Evidence session can be watched via Scottish Parliament recording (4)
I have followed the Mesh petition to the Scottish Parliament given my longstanding interest in ethics and consent. I should make it clear that I have no expertise in this specialist surgical area.
I submitted this short consideration ahead of the Evidence Session of the 18 May 2017 (5). I said in my submission:
"I agree with the Independent Review that 'robust clinical governance must surround treatment'. I am concerned that if the current situation continues, where 'education' of health professionals may be significantly based on marketing, further examples of iatrogenic harm may occur in NHS Scotland."
I concluded my submission:
"The Independent Review concluded that 'informed consent is a fundamental principle underlying all healthcare'. If the advice given to patients is based on marketing, either partially or wholly, then informed consent may be denied patients. Further examples of Iatrogenic harm may then unfortunately occur and healthcare in Scotland may risk being considered as unrealistic rather than 'realistic'."
At the Evidence Session of the 18 May 2017, those giving evidence, including Scotland's Cabinet Minister for Health, the Chief Medical Officer for Scotland, and the Chair of the Final Report talked about the importance of "truly informed consent" by describing that which has been set out by the General Medical Council in "Good Medical Practice".
Competing interests: I submitted a petition to the Scottish Parliament to consider a Sunshine Act for Scotland: http://www.parliament.scot/GettingInvolved/Petitions/sunshineact
Evidence against use of vaginal meshes is widespread. 
Lawsuits should also be extended to Surgeons and Gynecologists who persist in using them.
Women older than 50, with uterine prolapse, do not need to engage in strenuous abdominal and laparoscopic sacrospinous hysteropexies, just to keep an atrophic-non functioning organ, and sustain pressure onto their doctors to retain their uteruses at all costs. A quick vaginal hysterectomy, with or without anterior repair, is the best treatment, in my opinion. 
Minimally invasive types of hysterectomy evolved to become the only major abdominal surgical operations not associated with intra-operative or medium post-operative term mortality.
In fact, in certain age groups, even reduced mortality trends are evidenced. 
Various available hysterectomy techniques compete for operative times, length of hospitalization, hospital costs, blood transfusions, antibiotic use, antinociceptive medications, etc. 
Vaginal hysterectomies are better, faster, cheaper, preferred by women, definitive therapeutic interventions, compared to other available alternatives for benign conditions. 
Hysterectomies even increase sexual function and sexual pleasure. 
 BMJ 2010;341:c3929
Competing interests: No competing interests