TVT and pelvic floor update.

You couldn't make this crazy situation up.

Shine lawyers apparently have changed their minds are no longer including TVT/O's in their class action anymore!   Of course they are not - because there was never any evidence!!  That's great isn't it? 

Except now its too late.  The smell of money and a story meant Fake News in all its forms and the company who make TVT's got nervous.... so we now have no more TVT's.

I've told 3 women in the last 2 weeks they may have to live with their problem.  

What happens now? Will women be tempted by treatments with no evidence such as laser burning which has been brought in quickly just as mesh for prolapse was 15 years ago?

Despite the evidence-based literature and formal enquiries being supportive of TVT's for SUI and abdominal mesh for vault prolapse, the message resonating with women is that all mesh is possibly problematic.

Given the lack of clarity regarding the safety of some products, women in Scotland are electing to suffer an impaired quality of life rather than seek treatment.

In 2010–11, approximately 1400 continence operations were performed annually and by 2015–16 this number had reduced by 86% to approximately 200.

During the same time period, all prolapse interventions reduced by 37% from 1100 to approximately 700.[1]  Medicare and health funds will be happy.

Unfortunately, it seems that the role of educating the public on these devices has been assumed by journalists in the general media, lawyers in litigation and special interest groups on social media.

Going forward, we need to re-establish the community's confidence in the ability of the medical profession to treat female pelvic floor dysfunction in an open and transparent manner, while also being able to safely introduce and monitor new innovations.  

Due to all of this I don't see any innovation in the field for a long time.  Also I predict the best young gynaecologists will now avoid urogynaecology like the plague.  Why stress out with this unglamorous problem while you could do IVF and help people with having a baby instead?

These last  few years seemed to promise better times for women but the actual reality will be different for some.

I will perform the last retropubic TVT procedure next week on a patient who has recurrent incontinence after a TVTO.  Repeat surgery is always more difficult but with this particular situation with this particular product I know things will be fine for her and she will be cured.  I will be bringing out a video on Youtube of me performing one to see how simple it is/was to do.

I also intend to pressure the politicians and the company to bring back this option for women.  Join me.