Dr. Suzanne O'Sullivan:

When a woman comes to me with a problem, I will look at all the potential causes and try to treat those issues in the best way possible. One of the problems is some women want the mesh to be completely removed. If, as a clinician, I am fairly confident that doing so may not make their problem any better and has a high chance of making it an awful lot worse, leaving the woman in a much more devastating situation, I am left with a great ethical dilemma. I cannot recommend major and potentially mutilating surgery that I do not believe is in the interests of the patient. I just cannot do that. I have to be honest with women. It is not pushback. We are here to do our best and to try to help our patients and make them better. We have options to do that. As I have said, we offer many different things, including mesh removal where that is absolutely the right thing for the patient. However, it is very difficult when a patient believes total removal of the mesh is a panacea. As I have said, it is difficult when someone tries to push me into doing an operation I genuinely believe may be harmful and in no way good for a woman. I do not mean to push back but I can only be honest about what I believe will help somebody and what I can do to make that person better. Usually, we do not start with total mesh removal as the first step in dealing with issues, whether bladder problems, urinary tract infections, pain or difficulty with intercourse. The variety of symptoms and problems is absolutely enormous. There are, therefore, many options to deal with the issues and to make the woman better. There is no one quick-fix solution. That is where we have to be very careful. As I have said, we aim to provide a holistic multidisciplinary programme.