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The Problem with Mesh

Costs of Failed TVT Surgery

As we all know, the NHS is now bearing the cost of operating on patients whose breast or hip implants have failed years earlier than predicted with varying outcomes on the patient’s health and wellbeing.

The NHS must also bear the cost of remedial surgery when there are problems with TVT or other synthetic meshes.

When mesh surgery goes wrong, there are multiple trips to the GP, hospital clinic, costs of tests including ultrasound scans, urodynamics, MRI scans, and cystoscopies, and then eventually repeat surgery (and sometimes multiple surgeries) and hospital inpatient treatment to remove part or all of the tape which is eroding or causing obstruction or pain.  On top of this, add the cost of medication eg for pain or antibiotic treatment, and trips to the pain clinic for treatment or injections.  Throw in the cost of continence products, such as catheters, and you might have a better idea of the real cost to the NHS of failed TVT surgery.

The personal costs to the individual include: physical pain, suffering, ill-health and sometimes disability from TVT complications; costs to relationships and family life; disruption to working life and possible loss of income from repeated treatments and time off for surgery; and sometimes cost of funding second opinions and treatment out of desperation.

All surgery has risks and all surgery can fail.  But unlike other forms of continence surgery, synthetic mesh seems to pose unique risks from the plastic material causing erosion, infection, inflammation, tissue or organ damage and pain.  Plastic meshes cause misery and are fundamentally unsafe.

“Synthetic mid-urethral slings for stress urinary incontinence seem to have good success rates over long term, but they have a unique complication profile including de novo development of overactive bladder, voiding dysfunction, sling exposures, dyspareunia, and long-term pain. However, some of these complications seem to be related to wrong surgical indications and improper surgical techniques, although some complications may be directly related to the use of synthetic material itself.”

Failures and complications in pelvic floor surgery. Ashok K, Petri E
World J Urol. 2011 Dec 9
 
 
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Discussion

14 thoughts on “Costs of Failed TVT Surgery

  1. http://www.tvtno.org we are doing our best to get meshies united and help the many women suffering because of this horrible thing called Mesh!

    Posted by David | April 3, 2012, 2:06 pm
  2. Thank you, David. We can sometimes feel insignificant and despondent about this situation but hopefully the message will eventually get out there, and if we can only warn a few people considering having this mesh, then our websites have been worthwhile.

    Posted by tvtinfo | April 3, 2012, 2:13 pm
  3. alos would you like your blog linked on our site? we can exchange links. The problem is so many little groups we need to all unite and be heard!

    Posted by David | April 3, 2012, 2:30 pm
  4. Yes, sure, I think my site is aimed at UK readers but happy to have link.

    Posted by tvtinfo | April 3, 2012, 2:34 pm
  5. What happens when you lose your insurance well they help you.

    Posted by Frieda Dunbar | June 13, 2012, 5:14 pm
  6. I’m sorry Frieda, I can’t answer that question because here in the UK most people are treated under the National Health Service (NHS) which we pay for through our taxes. I don’t know much about the system of healthcare in the US. The NHS is free at the point of delivery for all UK citizens so we don’t normally have to worry about insurance. Some people prefer to be treated privately with private health care providers which they pay for usually through insurance but the vast majority are treated under the NHS.

    I assume you are in the US? Have you tried posting on the Topix forum:
    http://www.topix.com/forum/com/jnj/TTE0RAIRMP5EFC052/p159
    If you post the same question you might get some answers.
    Hope you can get some help with your issues.

    Posted by tvtinfo | June 13, 2012, 7:43 pm
  7. A document published by NICE in 2003 states: “The Gynecare TVT device costs £425 for a single device or £1185 for a pack of three, excluding VAT. The additional costs of materials used in the TVT procedure relative to some of the other surgical techniques are offset by a shorter operating time and/or hospital stay.” They calculate the shorter hospital stay associated with TVT placement as 2.9 days on average compared with 7.1 days on average for colposuspension. According to the document, the operating time is also shorter; a surgeon can perform three TVT procedures in the time it takes to perform two open colposuspensions.

    NATIONAL INSTITUTE FOR CLINICAL EXCELLENCE Final Appraisal Determination, Tension-free vaginal tape (Gynecare TVT) for stress incontinence 1993 http://www.nice.org.uk/nicemedia/live/11489/32562/32562.pdf

    Posted by tvtinfo | August 31, 2012, 6:39 pm
  8. The industry submission (ie from the tape manufacturers) contained an assessment of the cost–utility of TVT compared with open Burch colposuspension … at 1999–2000 prices, included time in theatre, hospital length of stay and complications.

    Costs were estimated at £1014 for TVT and £1317 for open Burch colposuspension, an average difference of £303. The study noted that although the cost of TVT tape is considerably higher than the theatre consumables used by open colposuspension, the shorter hospital length of stay required for TVT more than offsets this cost.

    Summary of Industry Submission as part of Health Technology Assessment for TVT device in 2002 (“Systematic review of the clinical effectiveness and cost-effectiveness of tension-free vaginal tape for treatment of urinary stress
    incontinence”):
    http://www.hta.ac.uk/fullmono/mon721.pdf

    Posted by tvtinfo | August 31, 2012, 7:13 pm
  9. hi i had tvt surgery in july 2010 after just a few days i was in extreme agony and visited my gp who examined my vagina and couldnt really see anything wrong but my sutures hadnt yet dissolved however upon my 6wk post op check at hospital the tape had eroded through my vaginal wall i was booked in for vaginoplasty to repair the eroision.after 6wk and a lot ov pain later the same had happened yet again another erosion found on post op check up .vaginoplasty 2nd attempt booked again .Post op check up 6wks later and yes another erosion! Removal of the tape is the next surgery planned .REmoval done then the surgeon wanted to give my tissue time to heel before 2nd attempt of inserting tvt .Iv had the surgery or attempted surgery but was unable to insert tvt as my tissue is extremely thin and tearing .I go to see the surgeon again next week to discuss what surgery he is going to perform this will be procedure number 6 with a 3month recovery period .My health before this was pretty good apart from severe incontinence im 38 years old but feel older n feel like im going through hell what i thought or was led to believe would be a simple procedureis actually a living nightmare and urge anyone to do a little research before having this surgeryi wish i had .

    Posted by jan | February 7, 2013, 9:41 am
  10. Sorry I have just noticed your comment here, Jan. Sorry to hear about all your problems with the tape eroding 3 times and 6 procedures altogether. Hope you have made a good recovery from the removal surgery. I’m amazed that they would suggest another TVT after all those complications! I really hope the surgeon has come up with an alternative solution to TVT mesh. Let us know how you are getting on.

    Posted by tvtinfo | March 19, 2013, 10:11 pm
  11. Has someone an idea what the costs are for injectable bulking therapy in the UK? We use Urolastic with a long- lasting effect in either primary patients or patients after failing TVT/TOT with high success rate. Total procedure including preparation takes max. 30 minutes. Local anesthesia and patient leaves after being able to void independently, normally within a few hours.

    Posted by Noes de Vries | August 2, 2013, 12:42 pm
  12. how much would a tvt operation cost in the uk

    Posted by deb | June 12, 2014, 7:52 pm
  13. Hi Deb
    The costs are different if done privately or on the NHS. I don’t have any recent information for NHS costs but as referred to above, the 2000 prices suggest over £1,000 so the costs would have gone up quite a bit since then. I do not have any information on the costs of having it done privately. Did any readers have it done privately?
    tvtnfo

    Posted by tvtinfo | June 15, 2014, 2:10 pm
  14. Very nice post. I certainly appreciate this website. daekedcbbeak

    Posted by Johne246 | September 10, 2014, 5:02 am

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