Pause on the use of surgical mesh for the treatment of stress urinary incontinence

In line with the Director-General of Health’s recommendation, and advice from our professional body RANZCOG, COGA gynaecologists will pause use of surgical mesh to treat female stress urinary incontinence (SUI), commonly known as the mid-urethral sling (MUS) procedure.

COGA's response

Effective 23 August 2023, a time-limited pause throughout Aotearoa New Zealand on using surgical mesh has been recommended by The Director-General of Health, Dr Diana Sarfati.

The reason for the pause is to enable the health system to put in place improvements that will mean better outcomes and a better experience for women who have mesh inserted as part of their incontinence treatment.

The recommendation allows for the use of mesh to treat SUI only where no other appropriate options are possible and a formal process is followed.

The pause is expected to be in place for several months.  It is important to note that this is not a ban on the use of surgical mesh for stress urinary incontinence. Nor does it prevent the use of surgical mesh in the treatment of prolapse.

During the pause on MUS procedures, women suffering from SUI will continue to have options for treatment. Female urinary incontinence is common and is often debilitating and can substantially reduce a woman’s quality of life. 

COGA doctors will treat patients suffering from SUI with our usual multidisciplinary approach that includes pelvic physiotherapy, as well as conservative management options such as pessaries.

For many women surgery is necessary to provide a more effective and enduring end to their symptoms and there are mesh-free surgical procedures available for treating SUI. Our surgeons are experienced in conducting these procedures.

 As always, we will carefully consider and discuss with our patients the range of treatment options available to them and support them to make an informed choice. Stress urinary incontinence can have a significant impact on quality of life and we urge anyone experiencing worrying symptoms to seek help.

Your questions

What does pause on MUS procedures mean for me?

If you have a planned mesh stress urinary incontinence procedure, we will be in contact to discuss options for management.

What options are available for treating SUI during the pause on the use of surgical mesh?

A range of treatments are still available and where there are no other appropriate options, there is an exceptions process for the pause to allow surgical mesh.

What should I do if I’ve had mesh inserted for stress urinary incontinence?

If you have had mesh inserted to treat stress urinary incontinence, there is no need to take any action unless you are experiencing complications. The decision to use mesh would have carefully been considered and was likely to have been the most appropriate option. Most patients have had successful stress urinary incontinence mesh procedures without complications.