Vaginal mesh particles ‘could trigger autoimmune response even after removal'
Microscopic particles left behind by vaginal mesh could continue to trigger the immune system to attack healthy tissue even after the material has been removed, according to researchers.
Experts suggest allergy testing patients before they are fitted with mesh may help to better understand why complications happen in some cases.
Campaign group Sling the Mesh said the majority of its members have developed a reaction they believe is down to the material, including autoimmune diseases, unexplained rashes and chronic fatigue.
Transvaginal mesh (TVM) implants are made from synthetic materials such as polypropylene, a type of thermoplastic, and have been used to treat pelvic organ prolapse and incontinence after childbirth.
However, they can cause serious harm to some women, with side effects including infection, pelvic pain, and incontinence.
The NHS restricted its use of TVM implants in 2018 and they are now used only as a last resort through a high-vigilance programme of restricted practice.
A new article led by Dr Nicholas Farr, published in the journal Nature Reviews Urology, analysed studies which suggest polypropylene is a material which causes autoimmune/inflammatory syndrome induced by adjuvants (Asia).
Asia arises following exposure to substances that enhance the immune response in the likes of vaccines, silicone implants, or other foreign materials.
Symptoms can vary widely, but include chronic fatigue and chronic pain.
It comes after previous work by Dr Farr, who is a research fellow at the University of Sheffield, showed polypropylene mesh started to degrade within 60 days of being implanted in the pelvis of sheep.
The study also found particles of polypropylene in the tissue surrounding implant sites.
Dr Farr told the PA news agency: 'Our previous studies have shown that polypropylene mesh can degrade and leave behind particles within the surrounding tissues.
'This is important because it raises a key question – what kind of clinical response might these particles trigger?'
'Earlier studies have explored links between mesh implants and systemic symptoms resembling Asia. Patients often reported that symptoms improved after mesh removal, but in some cases, they didn't fully resolve.
'These cases were described as involving 'complete' mesh removal. But our findings challenge that definition.
'We've shown that even after the mesh has been surgically removed, polypropylene particles can persist in the tissue.
'So, it may not be a truly complete removal – and that could help explain why symptoms persist in a subset of patients.
'Our findings offer a new perspective on earlier studies, suggesting that residual particles might be a contributing factor in ongoing immune responses, even after the visible mesh is gone.'
Dr Farr called for 'increased clinical surveillance of mesh patients' to keep track of any autoimmune symptoms, as well as allergy tests to consider suitability before they are implanted.
He added: 'While it is important to recognise that the majority of mesh implants do not result in serious complications, we need to better understand why complications arise in a subset of patients and ensure those experiences are not overlooked.
'It is also essential that we engage with patients who have lived experience of mesh complications, as their insights are vital to improving future care and guiding the responsible development of safer medical devices.'
Reacting to Dr Farr's latest findings, Kath Sansom, founder of campaign group Sling The Mesh, told PA it 'confirms what thousands of mesh injured patients have been reporting for years – that polypropylene mesh can lead to autoimmune disease, fibromyalgia and allergic reactions'.
'For too long, our voices have been dismissed,' she added.
'Now, science is catching up, and it's imperative that regulators and manufacturers take immediate action to prevent further harm.'
Ms Sansom told PA the findings underscore the need for revaluation of the material used in mesh, along with the importance of 'patient-centred approaches'.
'The majority of our group – nearly 12,000 people – have developed some sort of reaction believed to be from the plastic mesh including a wide range of autoimmune diseases, unexplained rashes, IBS, dry eyes and chronic fatigue,' she added.
Sharron Mahoney, 57, claims the vaginal mesh she had implanted in 2010 caused her immune system to go 'into overdrive', with symptoms either easing or disappearing when she had it removed in 2018.
She said: 'After receiving a rectopexy mesh implant, I began suffering from a host of unexplained symptoms – severe fatigue, joint pain, recurring rashes, and food and chemical sensitivities that I had never experienced before.
'I couldn't grip anything, was losing my vision, had chronic cough, post nasal drip. Dry eyes. Stiff and sore muscles. Rashes on my skin.
'Doctors struggled to find a cause and treated me like a mystery – I later found out they put 'may be psychological' in my notes.
'When I finally had the mesh removed, the change was extraordinary – the allergic reactions instantly eased, my energy slowly returned, and many of the autoimmune symptoms diminished or disappeared entirely.
'My experience has left me in no doubt that the mesh was causing my immune system to go into overdrive.
'Patients need to be heard, and we need robust, long-term research and regulation to prevent others from suffering needlessly.'
A 2024 report by Patient Safety Commissioner Dr Henrietta Hughes highlighted that thousands of women's lives were 'destroyed' because of pelvic mesh.
It called for the Government to create a two-stage financial redress scheme.
However, in February – a year on from the report's publication – campaigners said they have 'faced silence', with no compensation scheme put in place.
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