Warning: Graphic content
A 35-year-old mum says she's been left crippled by surgical mesh implanted into her body, allegedly without her informed consent.
Kate's* failed operation, which took place in July last year, came three years after the Government ordered hospitals to take action to protect women from harm caused by mesh, which is used to treat birth injuries.
"It makes me incredibly angry," the Taranaki mum-of-two told the Herald.
"I mentioned my hesitancy to mesh throughout this whole process and two separate doctors assured me this wasn't something to be concerned about."
She decided to speak out after reading the Herald report on Sally Walker, 73, who described her insides being so badly damaged by mesh that her bladder had to be removed and her vagina sewn closed.
Kate is one of dozens of women whose care is being examined by New Zealand's Government-funded health watchdog, the Health and Disability Commission (HDC), set up to protect and promote patients.
She said the plastic mesh buried inside her felt like a grater rubbing against raw wounds on her pelvic organs.
Her bladder leaked without warning which meant she could no longer jump on the trampoline, or run around with her two young kids on their back lawn.
She also couldn't have sex with her husband because the 20cm-by-1cm piece of woven plastic made it too painful.
Kate believed her suffering might have been prevented if her surgeon had implanted the mesh correctly or if she had been given all relevant information, such as the risks and alternative options, before operating.
"I feel like I got coerced into getting mesh as I didn't get the full picture," Kate said.
She agreed to share her experience with the Herald without being identified as she was still dealing with trauma from her injury. Kate is not the woman's real name.
After the birth of her first child in 2018, she developed stress incontinence, a common afterbirth injury involving the loss of bladder support which leaves a woman urinating without warning.
The problem got worse after she had her second child in 2020.
"I would go for a walk and my pants would be wet through, sneezing, coughing, yelling and any exercise caused me to leak and this didn't get better with time."
By March last year, she sought help from a gynaecologist who suggested she needed a TVT (tension-free vaginal tape) mesh sling and referred her to someone who "was the best and taught many people how to do the surgery", Kate said.
She said in her complaint to HDC that the surgeon — who the Herald has chosen not to name — performed an ultrasound on the full bladder and again recommended mesh and a Mirena IUD to control heavy bleeding.
"I discussed again my hesitancy to mesh and from memory [the surgeon said they] had no cases of mesh complications with the sling procedure."
Kate said in her complaint that the surgeon told her mesh was less invasive than a facial sling and it was the gold standard for treatment. The surgeon had assured her they had performed "vast numbers of these surgeries".
She went ahead with the surgery based on the information given.
"The surgery seemingly went well, I took it easy for the next seven weeks, only light exercise and no heavy lifting." she said.
Then she decided to test the operation's impact by going for a run.
"I realised the surgery hadn't worked at all. I was drenched in urine as I would have been prior to surgery," she said in her complaint.
Now, she said, she felt worse than before the mesh was implanted.
"Not being able to have sex with my husband has obviously created some intimacy problems and put a strain our relationship."
Kate said she wished she could run around and play with her young kids but she could only watch them or else would wet herself.
"It's been really hard ... I used to run and do cross-fit and I can't do that anymore and I have to be planning my day carefully to make sure I'm always close to a toilet."
The toll on her mental health had been huge.
READ MORE STORIES FROM OUR IN HER HEAD PROJECT
"It's embarrassing ... I remember leaking after trying to run and just thinking what's the point anymore."
Kate has since seen urologist Dr Hazel Ecclestone and has arranged to get the mesh removed this month by Auckland urologist Eva Fong.
Ecclestone said in a letter to Kate's GP Dr Keith Blayney: "It appears that the sling was difficult to image as it sits 4mm above the external urethral meatus (the urine hole)."
The sling was therefore sitting towards the bottom of Kate's urethra (urine tube), which medical records showed was 32mm long.
In a study published in the International Urogynecology Journal this year, researchers concluded that mesh was most successful if positioned around the middle of the urethra.
"Technical and positioning errors can lead to the failure of anti-incontinence surgical treatment," study researchers said.
The study tracked 80 women who had mesh implanted for urinary incontinence in Italy over a six-year period. It's understood to be the first study to follow patients through ultrasound and look at the mesh position over a long period.
After six years, 64 of the women said they had stopped leaking. Of those, 61 had the sling in the middle of their urethra. But none of the 16 who were still leaking had the sling in this position. The study concluded that the chance of the mesh operation working was much higher if it was positioned correctly in the middle of the urethra.
Ecclestone's letter also said Kate had found a firm lump to the left of her urethra, which was likely to be a folded edge of the mesh. She suggested Kate should apply to ACC for a medical treatment injury.
Kate had since lodged a claim, which was accepted.
The Herald contacted the surgeon who implanted Kate's mesh for comment and received a response from medical lawyer Harry Waalkens saying the surgeon "rigorously rejected any criticism that [they had] acted unprofessionally or otherwise inappropriately" in the management of her case.
An HDC spokesperson said Kate's complaint was in the early stages of assessment. "We are unable to comment on the specifics of any case in order to ensure the integrity of a fair and impartial process for all those who are involved in a complaint."
The agency acknowledged the significant harm caused to some New Zealanders due to surgical mesh products and understood why those people were concerned.
• In Her Head is a Herald campaign for better women's health services. Reporter Emma Russell investigates what's wrong with our current system and talks to wāhine who have been made to feel their serious illness is a figment of their imagination or "just part of being a woman".
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Comment: Planting a range of trees will give fruit at different times of the year.