Grŵp Iechyd a Gwasanaethau Cymdeithasol
Health and Social Services Group
ATISN 15735
John Cena
c/o Ryan Coleman
xxxxxxxxxxxxxxxxxxxxxxx@xxxxxxxxxxxxxx.xxx
December 2021
Dear Mr Cena,
ATISN 15735 – Vaginal Mesh
Thank you for your request to the Welsh Government for information under the Freedom of
Information Act (2000) received on 01 December relating to vaginal mesh removal. You
have requested the following:
The number of people who have had the Transvaginal Mesh Removal procedure in
Wales Since 2010
Our Response
Welsh Government does not hold all the information that you are requesting. The
information we hold only covers the period to 2017/18.
There is also a possible definitional issue with the request and data we hold, in that the
actual figures we have are a combination of a number of different procedure codes and
might not reflect the definition of transvaginal mesh removal procedures which the FOI
requestor requires.
The table below shows the number of patients who have had a vaginal mesh or tape
procedure in each of the financial years 2007/8 to 2017/18 and the number of episodes of
care in Wales over the same period:
Parc Cathays ● Cathays Park
E-bost E-mail:
Caerdydd ● Cardiff
HSSBriefingsandMeeting@gov.wales
CF10 3NQ
The figures have been provided by the NWIS Classification and Terminology service using
the OPCS Classification of Interventions and Procedures version 4 codes, held on the
Patient Episode Data Base for Wales (PEDW) and include figures for finished consultant
episodes (FCE) with end dates in the date range 1st April 2007 to 31st December 2017.
The figures show that over the period 2007 to the end of 2017 there were 6944 finished
consultant episodes in which procedures implanting mesh or tape were carried out. During
the same timescale there were 503 finished consultant episodes for total or partial mesh or
tape removal or over-sewing. Detailed information on the specific procedures is not
available as many of the classification codes used over this period did not differentiate
between partial or total removal of mesh or tape.
A total of 6,859 patients received mesh implants and a further 436 had mesh removed or
had undergone mesh over-sewing. There are more episodes of care than individual
patients as a number of the patients will have received more than one episode of care
related to vaginal mesh.
The use of mesh and tape implantation has been on a downward trend over the period
investigated, falling from a peak of 980 episodes in 2008-9 to 328 in 2016-17 and 144 over
the first 9 months of 2017-18. Episodes of mesh removal have also fallen since 2007-8 but
have stayed steady over the last 8 years with an average of about 40 episodes a year. The
over-sewing of exposed mesh has seen very low numbers with a total of 12 episodes over
the ten year period reviewed.
Methodology for Welsh Data on Mesh Implant and Removal:
These figures provide a count of the number of finished consultant episodes in which a
specific procedure has been recorded as being undertaken, and the number of patients who
have undergone any of these procedures. Any given patient may be responsible for the
appearance of more than one incidence of a procedure or procedures - for example if they
had an implantation, followed by one or more partial removals and then a total removal.
The figures include all
procedures carried out for stress incontinence, vaginal or uterine
prolapse in which mesh or tape has been inserted, removed or over-sewn only when one of
the following applied:
1.
The words ‘mesh’ or ‘tape’ is included in the OPCS descriptor for the
procedure.
2.
The codes are present on NHS Digital, Table of Coding Equivalence for any of
the procedures in point 1. The NHS Digital, Table of Coding Equivalents
provides details of changes in OPCS Classification code(s) that have occurred
due to the release of any new version of the classification.
3.
There is a specific Clinical Coding Standard with direct instructions on how to
record one of the procedures covered by this report.
The Classification Team acknowledges that it is possible that mesh could have been
inserted during procedures that are not included in these figures. However, it is not possible
to use clinical coded data to identify these procedures.
The figures on these procedures have been divided into three distinct sections:
1.
Procedures that include the implantation of mesh or tape
2.
Procedures that include removal of mesh or tape (both Partial and total
removal)
3.
Over-sewing of any exposed mesh or tape in the vagina
The DHCW Classification and terminology team would like to clarify that it is not possible to
identify the type of mesh implanted (prosthetic) (biological) using historical clinical coded
data. However, the team with the assistance of interested clinicians is in the process of
drafting a new Welsh Clinical Coding Standard. In the future, if the type of mesh used has
been documented within the medical record the use of this proposed standard should allow
easy identification of the type of mesh used. It is hoped that this new standard will be
mandated for use by the Clinical Coding Service in NHS Wales on any finish consultant
episode (FCE) with an end date on or after 1st April 2018.
For further information, you may wish to contact Digital Health and Care Wales. For your
convenience, their contact details are as follows:
Digital Health and Care Wales
Tŷ Glan-yr-Afon,
1 Cowbridge Road East,
Cardiff, CF11 9AD
Email:
Freedom of Information Requests
Next Steps If you are dissatisfied with the Welsh Government’s handling of your request, you can ask for
an internal review within 40 working days of the date of this response. Requests for an
internal review should be addressed to the Welsh Government’s Freedom of Information
Officer at:
Information Rights Unit,
Welsh Government,
Cathays Park,
Cardiff,
CF10 3NQ
o
r Email: Freedom.ofinformation@gov.wales
Please remember to quote the ATISN reference number above.
You also have the right to complain to the Information Commissioner. The Information
Commissioner can be contacted at:
Information Commissioner’s Office,
Wycliffe House,
Water Lane,
Wilmslow,
Cheshire,
SK9 5AF
However, please note that the Commissioner will not normally investigate a complaint until it
has been through our own internal review process.
Yours sincerely,
Jeanette Warren
Government Business Manager
Government and Corporate Business Team
