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Professor Hashim Hashim response to Convener's letter - Transvaginal Mesh Removal (Cost Reimbursement) (Scotland) Bill

Letter from Professor Hashim Hashim in relation to the Transvaginal Mesh Removal (Cost Reimbursement) (Scotland) Bill - 19/10/21

Thank you for your letter dated 14/09/2021.

 

Please find below replies to your questions.

 

• How many individuals from Scotland have travelled to you for mesh removal surgery so far?

 

Three patients.

 

• How many individuals from Scotland have already entered into private arrangements with you for future mesh removal surgery?

 

None

 

• When do you anticipate surgeries to start taking place under the new contract with the NHS?

 

I am not aware of the starting date. Spire health care will be discussing that with NHS Scotland.

 

• Can you provide an estimate on how many more individuals will come forward to use your services under the new contract with the NHS?

 

I don’t have that information as it’s the NHS Scotland decision. All I know there is a lot of interest from patients.

 

• We understand that removal surgery can be different for every individual, but can you provide an average cost for complete mesh removal?

 

The cost for each type of mesh removal was already provided to NHS Scotland at the time of tendering.

 

• Can you give us some indication on what makes the surgery so complex or specialised?

 

1. The position of the mesh in the vagina and/or pelvis means that there are several organs, nerves and blood vessels in close proximity to the mesh making it a specialised surgery.

 

2. Female functional and reconstructive urology is a sub specialist area within Urology.

 

3. Mesh removal can lead to complications and therefore needs special skills to avoid these complications and manage them if they occur.

 

4. A multidisciplinary team is often required with Urologists, orthopaedic surgeons, Urogynaecologist and/ or colorectal surgeons.

 

5. Some patients require concomitant procedures at the same time of mesh removal.

 

• In your opinion, is it possible that individuals may require any other physical or mental health treatment related to their transvaginal mesh or mesh removal?

 

Yes. Many patients require non-surgical multidisciplinary input including clinical psychologist, pain specialist and pelvic floor physiotherapist.

 

• Does the average cost for the surgery also cover the treatment of other conditions or circumstances that arise either prior to, in the course of surgery, or post-operatively?

No

• Does the cost cover post-operative care and support, and if so, for how long?

No

Yours sincerely,
Professor Hashim Hashim
Consultant Urological Surgeon