The Department of Health’s latest response to a question on pelvic mesh removal highlights significant gaps in transparency and leaves several important questions unresolved.

Namely – how are surgeons being trained in mesh removal? How many surgeons are performing mesh removal? Are surgeons linking up their expertise to ensure women receive the same care regardless of which centre they are seen at?

Is there a sample retrospective audit being carried out to calculate mesh complication risks as recommended in the First Do No Harm review?

The Government confirms that both partial and complete mesh removal are recognised treatment options under NICE guidance and between 2021 to 2025 there were 234 full mesh removals and 185 partial mesh removals. A total of 419 procedures.

An average mesh removal in the UK (2026) costs £16,000. So in five years alone mesh removal has cost the NHS more than £6.7million. That’s before factoring in pain management, mental health support, medication and the cost to the benefit system where women have had to give up work.

The government response to our questions – asked by MP Sharon Hodgson – reveals that information on how many surgeons are carrying out mesh removal procedures in the nine specialist centres is “not held centrally”.

More notably, the Department failed to answer a key question: are mesh removal surgeons specifically trained in complete mesh excision and removal techniques? Instead, it simply states that specialist centres must ensure surgeons are “appropriately trained” through local trust appraisal systems. Patients deserve greater clarity about what that training involves and how expertise is assessed.

Finally, the response raises questions about the implementation of Baroness Cumberlege’s landmark First Do No Harm report around a retrospective audit. While the Department says a sample audit of the POP/SUI database has been completed and used to inform future commissioning, it does not explain whether a broader retrospective audit of mesh cases has been undertaken. The First Do No Harm review suggested taking a sample year of 2010 of women implanted to see how they are now. But that piece of work seems to have been ignored.

For many mesh-injured women, the issue is not whether mesh complications and services to treat them exist, but whether the NHS and Government are being fully transparent about outcomes, expertise and lessons learned.

Partial vs Full mesh removals

NICE guidance allows both full and partial mesh removal. Yet many women who undergo a partial removal later require further surgery when symptoms persist or complications continue. Our mesh community advocates for complete removal first time, wherever clinically possible and appropriate.

We are increasingly concerned about reports from women who feel steered towards partial removals, being told they are less invasive, less demanding on the body, and more likely to provide relief. But if a partial removal fails and further surgery is needed, the physical, emotional and financial cost only grows.

A key question is: when is the Patient Decision Aid provided, before the consultation or after treatment options have already been discussed?

See P165 of First Do No Harm report for the call for a 2010 retrospective audit