Pelvic mesh complication clinics (PMCCs) were established in each Australian state following a senate enquiry into the use of artificial mesh implants for the management of pelvic organ prolapse and stress urinary incontinence.
This study aimed to describe the characteristics and clinical care pathways of women presenting to a PMCC at a tertiary hospital in Western Australia. The relationships between neuropathic pain symptoms and depression anxiety stress scale (DASS) scores with referral to pain medicine and psychology, respectively, were investigated.
A retrospective cohort study utilising clinical files of 74 women who attended a mesh complications clinic between 2017 and 2024.
The mean age of women presenting to the PMCC was 60.6 years, with concerns including urinary leakage (82.4%), bowel symptoms (78.6%), pelvic pain (98.6%), possible/highly likely neuropathic pain (56.8%) and dyspareunia (78.7%). The median wait from referral acceptance to urogynaecologist consultation was 185 days (quartile one, quartile three; 116, 367). Management included topical oestrogen (83.8%), referral to physiotherapy (87.8%) and pain medicine (87.4%) with median (quartile one, quartile three) wait to referral of 0 (0,0) and 0 (0,14) days, respectively. A greater proportion of those categorised as possibly/highly likely to have neuropathic pain were referred to pain medicine (p = 0.005). Only 13.5% were referred to psychology, with no association between those referred and higher combined score on the DASS (p = 0.205).
Most women attending a PMCC reported a variety of urogynaecological and pain symptoms, requiring an evidence-based, timely, individualised and multidisciplinary management approach.
The Australian & New Zealand journal of obstetrics & gynaecology. 2026 Apr [Epub]
Marika Hart, Andrea Atkinson, Linda Goransson, Yamini Kapoor, Kiera Rogerson, Chelsea Schapel, Kelly Chilvers, Elizabeth Edwards, Agner Grieco Hazewinkel, Annissa Harwood, Sinead Hornby, Todd Ladanchuk, Charlotte Hosking, Leanda McKenna, Emma Wise, Darren Beales
Department of Physiotherapy, King Edward Memorial Hospital, Perth, Western Australia, Australia., Department of Urogynaecology, King Edward Memorial Hospital, Perth, Western Australia, Australia., Curtin enAble Institute and Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia.