The mesh in my body is a 'ticking time bomb'

Sam Hindle has 23cm of polypropylene mesh in her body and lives in constant fear that it will become unstable and cause irreversible damage.

"You are in your own Battle Royale, strapped to a time bomb, and thinking when is it going to go off," she told the BBC.

"I've had it in for 18 years so I have got to be pushing my luck. You don't know when it is going to go off and what damage it is going to do."

Sam, 46, is one of hundreds of women in Scotland who have suffered life-changing symptoms since they had a transvaginal mesh implant.

After years of campaigning by the women, the Scottish government has promised it will cover the costs of mesh removal at private clinics in the UK and US.

But Sam has been waiting more than two years just for a referral to the Complex Mesh Surgical Service in Glasgow to start the process.

Tens of thousands of women had transvaginal mesh implants in Scotland to treat incontinence and prolapse, conditions many women suffer after childbirth.

The implant procedure has since been halted because of the life-changing side effects many women suffered.

The Scottish government announced last year that it had signed a contract to allow NHS patients to visit a US expert for mesh removal surgery

The contract with Gynaecologic and Reconstructive Surgery of Missouri, where Dr Dionysios Veronikis operates, follows a similar contract agreed with Spire Healthcare in Bristol.

The cost of each removal procedure is estimated to be £16,000 to £23,000.

But in order to access such treatment, women have to be assessed by the national service in Glasgow.

Women like Sam say there are waiting years to just get referred for assessment. With further delays for appointments and then waits for surgery.

"You start to think: 'Am I ever going to actually see this doctor in America?' Because I certainly don't feel like it at the moment," Sam said.

She has been told she has to get a number of tests done locally, including an MRI, before she can be referred to the national service. She is still waiting for further tests to be completed.

Sam says the constant pain is like "claws ripping you from the inside". She wears pyjamas for the interview with us because she can't bear the discomfort of clothes.

Dr Wael Agur, a member of the Scottish government working group on transvaginal mesh, said: "Time is of the essence.

"The longer the mesh stays in the higher the risk something can go wrong," he said.

"For those who already have complications, time is even more important because of the ongoing chronic inflammation - due to the continuous foreign body reaction and the risk of mesh erosion - of the mesh cutting into organs like the bladder and bowel."

Dr Agur said the current pathway to treatment was not working and there were bureaucratic steps which could be removed to significantly speed it up.

Isobel McLafferty, 53, from Scottish Mesh Survivors, paid to be treated by Dr Veronikis in the summer of 2022 after she was told by the mesh clinic that there was no clinical case for removal surgery.

She now advocates for others who want treatment in the US. She says the pathway needs to be streamlined and made more user-friendly.

Isobel said: "This system of getting to America, or getting an appointment in the first place at the mesh centre, is difficult.

"You have nine months to over a year to wait.

"Women are then coming up to their appointment time full of anticipation, ready with questions, and then their appointment is cancelled. Then it's rescheduled for several months down the line. They are living on a day-to-day hoping for support and it's not coming."

Dr Veronikis told BBC Scotland the delays to mesh removal surgery affects the daily quality of life of patients, both physically and mentally.

He said his clinic had received 13 referrals from the NHS so far, nine of which of which had already undergone surgery.

Three others are currently scheduled and one recent referral had an appointment for a video consultation.

"This referral pathway for the surgical management of mesh complications is unprecedented and very unique for the NHS," he said.

Women's health minister Maree Todd said the process was "relatively speedy" once women reach the national service in Glasgow and that overall the NHS is beginning to recover from winter pressures but that such delays are "unacceptable".

"It's not acceptable and I'm really sorry that people are waiting," she said.

"Actually the service is relatively fast, once you get referred in you should be seen within a matter of months.

"So I would absolutely suggest to those women who say they've been waiting years to go back to their GP initially and to chase up those referrals to the Glasgow centre."

Roseanne McDonald, associate director of specialist services at NHS National Services Scotland (NSS), said: "More than 140 assessments have been carried out to-date and by the end of 2022, fewer than 100 patients are awaiting assessment.

"The average waiting time for assessments following referral is around six months which has been achieved through the hard work of NHS colleagues and despite the continued challenges caused by Covid-19 and other pressures on NHS services.

"To-date, 32 patients have been referred to independent providers."