Patient journey

Outpatient appointment -Before your clinic appointment, you will be sent some quality of life questionnaires, please bring the completed questionnaires to your appointment.

We endeavour to make your clinic visit as short and seamless as possible and you are welcome to bring a friend, relative or partner with you if you wish. Several members of the multi-disciplinary team who discussed your case will be present during your appointment. You will also be asked to complete a urine sample for testing. 

Investigations - These are sometimes performed before you are seen in clinic, others, the consultant may wish to see you first before requesting investigations. The results will help determine which treatment will help you best. More about the kinds of investigations you may be referred for can be found below, under the investigations subheading. 

Following an outpatient assessment and the necessary investigations being completed, your consultant will discuss your treatment options with you. Based on your symptoms, presenting complaints and personal wishes, you will be given a range of options for treatment.

Pain management - You will be offered an appointment with one of the pain consultants who are able to provide treatment designed to reduce the impact of pain on a person’s life. This involves discussions around medications alongside exploring ways of living well with pain and increasing activity. This appointment may be carried out jointly with our psychologist.

Psychology - You will be offered an appointment with a psychologist to help you with a range of concerns that may be affecting your emotional or psychological wellbeing. Please note, psychologists will not prescribe medications.

Physiotherapy - At any point on your patient journey you may be referred to see a women’s and pelvic health physiotherapist who can help support women with symptoms of bladder, bowel or sexual dysfunction or persisting pelvic pain.

Surgery - Not all mesh patients need mesh removal, but the consultant and you decide on this, you will be added to the waiting list for surgery. The waiting times will be advised when/if the decision for surgery is made. More about surgery can be found below, under the surgery subheading. 

Investigations

Cystoscopy - This involves putting a telescope in your bladder. This is to investigate whether the mesh has perforated into the bladder or bladder outlet pipe (urethra).

Urodynamics Studies - Urodynamics is a test for finding out how your bladder, sphincter (the muscle around the neck of your bladder) and the urethra (the tube that carries urine out of the body) are working. The test can help find out the cause for bladder problems such as incontinence, or difficulty in passing urine.

Ultrasound - An ultrasound scan uses high-frequency sound waves to create an image of the inside of the body. It is not unusual for you to need more than one ultrasound during the diagnostic period, the second will normally be a specialist ultrasound called a translabial (this is used to look specifically at the mesh / tape and performed by a specialist sonographer).

MRI - Magnetic resonance imaging, or MRI for short, is a method of obtaining highly detailed pictures of the inside of your body. A powerful magnet, radio-waves and a computer are used. The technique does not use x-rays and there are no known side effects. The procedure is painless and can be used to image most body areas.

CT - STH has state-of-the-art computerised tomography (CT) scanners that use x-rays to obtain pictures of your body in slice sections. These pictures are then examined by a team of specialists and will help diagnose any problems.

EUA - Examination under anaesthetic allows your doctor to examine you thoroughly under general anaesthetic and check the mesh.

Surgery

If surgery is needed to manage mesh complications, the following procedures may be recommended:

• Vaginal removal of mesh
• Abdominal mesh removal
• Laser removal

What to expect

Full details about surgery will be discussed with you when/if you are added to the waiting list.

Before surgery you will have a pre-assessment and on the day of the surgery the consultant, anaesthetist and clinical nurse specialist will meet with you.

After surgery you will be advised on your plan for going home, symptoms to look out for and when to seek medical advice. A going home after mesh removal surgery information factsheet will also given to you.