The Leicester Specialised Mesh Complications Service
The Leicester Specialised Mesh Complications Service at University Hospitals of Leicester NHS Trust was set up in August 2021 in response to recommendations by the First Do No Harm report. We are one of nine specialist centres in England supporting and treating women with mesh complications after surgery for urinary incontinence and vaginal prolapse. We are based at both Leicester General Hospital and Leicester Royal Infirmary.
You can find out more about pelvic mesh complications here: Specialised services for women with complications of mesh inserted for urinary incontinence and vaginal prolapse
We have a multi-disciplinary team (MDT) which includes surgeons, imaging specialists, pain specialists, nurse specialists, physiotherapists and clinical psychologists.
Miss Carmen Hoh
Mr Chris Mann
Mr Krishna Varadhan
Mesh MDT & data coordinator
Dr Karim Shoukrey
Mr Sanjay Varma
Dr James Stephenson
Dr Sarah Hudson
Mr Rod Teo
Mr Douglas Tincello
Miss Aneta Obloza
Miss Pravisha Ravindra
Mr Jas Rai
Making a referral
We accept referrals from GPs and hospitals from the Midlands. Referrals can be made by e-mail to the UHL Mesh Mailbox at email@example.com via the NHS e-Referral Service (e-RS) to Urogynaecology or Urology.
Referrals received via the UHL Mesh Mailbox are acknowledged within 24 hours. All referrals are initially discussed at the monthly MDT meeting and referrers will be notified of the date and time for this. An invitation for referrers to join the discussion virtually is offered. Patients will be informed of any investigations that are required and an outpatient consultation will be arranged.
Leicester Specialised Mesh Complications Service Contact details:
Amina Pirji (Mesh MDT & Data Coordinator)
Telephone: 0116 258 4817
Training for GPs
A programme to help GPs better understand pelvic mesh complications is available through Health Education England e-learning for healthcare. This resource has been developed to aid GPs’ awareness and understanding of pelvic mesh, their potential complications and symptoms and the referral process to specialist mesh centres.
For more information and to access the resource, please visit the Pelvic Mesh Complications programme page.
Frequently asked questions for women coming to the Leicester Specialised Mesh Complications Service
Why do I need to be seen in Leicester rather than locally?
Mesh complications need to be assessed and treated at specialist centres where the expertise is available. There are 9 such centres in England and the Leicester Specialised Mesh Complications Service covers referrals from the Midlands.
What should I expect at my clinic appointment?
Even before you attend clinic, your case would have been discussed at our MDT meeting. At this meeting, the team may decide that a few more investigations are needed. If so, you will be informed and the investigations organised for you. These investigations will need to be carried out in Leicester. Common investigations include scans to look at the mesh more closely (MRI or ultrasound), flexible cystoscopy (bladder telescope test) and urodynamics (an investigation for urinary problems).
You will be seen by a Consultant at your appointment. You will be asked about the problems you are experiencing and it is very likely that you will have an internal (vaginal) examination. You may already have had some investigations before your appointment and the results will be explained and discussed with you.
We will discuss a treatment plan for you once we have all the necessary information. You will be given plenty of time to think about the proposed treatment and to ask questions. All treatments are discussed and agreed at regular MDT meetings. We will also provide you with written information about your treatment.
Not all treatments involve surgery and you may need to see other members of the team for non-surgical treatment. Effective non-surgical treatments may involve seeing a pain specialist, physiotherapist, nurse specialist for urinary and prolapse problems or clinical psychologist.
Information on flexible cystoscopy can be found here.
Information on urodynamics can be found here.
Can someone come with me to my appointment?
Yes, you can bring someone along with you and we would encourage you to do so. You may feel more relaxed if someone is with you and they can also help you remember details of the discussion.
How long will I have to wait for surgery?
This is uncertain and based on clinical urgency. We will however make every effort for you to have treatment as soon as possible.
If your surgeon has recommended that you need an operation, you will be asked to attend a pre-operative assessment clinic before your surgery. This is usually take place 1 to 2 weeks beforehand.
This appointment can take a few hours and is to make sure you are well enough and fully prepared for your surgery.
The pre-operative assessment nurses will arrange all relevant tests. You may have several tests and investigations at the clinic or scheduled for another date. These tests need to be carried out in Leicester so that we have all the results readily available to us before your surgery.
Follow-up after surgery
You will continue to be followed-up after your surgery. We provide long-term follow-up for up to 5 years. Appointments can be in-person or by telephone depending on what is appropriate and convenient for you.
Information about surgery
The decision aids provide you with information about the different types of surgical treatments that are available. They range from minor to major operations. Along with your surgeon, the aids help you decide the type of treatment you should have.
Decision aid: Removing mesh for urinary leakage –This explains surgical treatment options for mesh complications where mesh (tapes) was inserted for leakage of urine. Generally two types of tapes were used. A retropubic tape (TVT) has portions of mesh in the vagina and pelvis. A transobturator tape has portions of mesh in the vagina and inner thighs.
Decision aid: Removing mesh for prolapse– Mesh for prolapse could have been inserted through the vagina or through the tummy (abdomen). Abdominal mesh operations lift the top of the vagina or womb and are attached to the backbone higher up in the pelvis. Mesh inserted through the vagina lies under the lining of the vagina. They may have mesh arms that anchor the mesh in place.
Removal of transobturator tape (TOT)
Removal of retropubic tape (TVT)
Removal of vaginal mesh for prolapse
Removal of abdominal mesh for prolapse
Getting to Leicester
Travelling to the Leicester Royal Infirmary
Travelling to the Leicester General Hospital
Contact details Leicester Specialised Mesh Complications Service
Amina Pirji (Mesh MDT & Data Coordinator)
Telephone: 0116 258 4817