Chamber and committees

Alternative treatment options to transvaginal mesh implants for vaginal prolapse include pelvic floor exercises, changes to diet to reduce weight, eating a high-fibre diet with plenty of fresh fruit, vegetables, wholegrain bread and cereal, the use of vaginal pessaries or a range of surgical techniques.

There are a number of treatment options available for stress urinary incontinence. These include changes to diet to reduce weight and physiotherapy to strengthen the pelvic floor muscles. Surgical treatment is recommended only if conservative (non-surgical) management is ineffective. There are a number of surgical procedures for this condition.

The information requested is not held centrally.

This information requested is not held centrally. Information on the number of procedures undertaken to remove transvaginal mesh implants is not available as there is no specific clinical codes used for this type of procedure. However, the following table provides information on the number of procedures for unspecified removal of prosthesis from organ or the removal of other unspecified repair material from organ that may include removal of transvaginal mesh implants:

Source: NHS National Services Scotland Information Services Division.

There have been no recent changes to the risk classification of Transvaginal Mesh Implants.

The Deputy Chief Medical Officer and colleagues have recently participated in two telephone conferences and three review conversations with the Medical and Healthcare products Regulatory Agency. These discussions focussed on medical device regulation.

The Scottish Government is not considering suspending the use of transvaginal mesh implants.

Discussion on an implant registry is on-going, and includes the British Society of Urogynaecology (BSUG), The British Association Urological Surgeons, the Royal College of Obstetricians and Gynaecologists and the Medicines and Healthcare products Regulatory Agency.

There is an existing BSUG database, currently being used by 20-30% of urogynaecologists, that may be adapted to record procedures, complications and some outcome data for specific urogynaecological procedures, including the urethral tape and vaginal mesh insertion procedures. A number of Scottish clinicians already contribute their data to the BSUG database and we will work with the Scottish Association of Medical Directors to identify the barriers to using the database amongst Scottish clinicians so that we can find ways of increasing uptake.

This information is not held centrally.

The Specialist Feeding Clinic at Yorkhill Hospital is provided for children living in NHS Greater Glasgow and Clyde or other children under the care of tertiary consultants at Yorkhill Hospital. There is no formal arrangement to accept referrals (of children not under the care of tertiary consultants at Yorkhill) from other NHS Boards in Scotland, though such children have occasionally been seen on an individual basis. Referral to the specialist feeding clinic from out with NHS Greater Glasgow and Clyde is a matter for the clinician leading on the child’s care.

All tertiary consultants in the Royal Hospital for Sick Children (Yorkhill) are aware of the up-to-date referral pathways to service and what care models can be offered.

A portfolio of leaflets and materials has been developed for parents.

Lessons learned within the feeding clinic are disseminated via education locally and nationally. It has an active programme of research.