A Perth doctor was left speechless after Federal Senators at a pelvic mesh inquiry in Perth on Friday said women unable to have vaginal sex after mesh surgery "repeatedly" reported that their doctors suggested anal sex as an alternative.
"I'm truly shocked a colleague would say that to a woman. I am aghast. I feel awful," said urogynaecologist Dr Michelle Atherton, after Senator Hinch asked if that kind of response from doctors was why pelvic mesh victims felt so betrayed.
Dr Atherton, who wrote one of the earliest Australian research papers warning about serious complications in women implanted with the Australian-invented Tissue Fixation System (TFS) device, was stunned by the suggestion.
But inquiry chair Senator Rachel Siewert said: "It's been told to us repeatedly."
Adelaide-based TFS Manufacturing, owned by former Australian champion basketballer and Newcastle Falcons player Paul Zadow, has appealed to the Australian Administrative Appeals Tribunal against the device's cancellation in 2014. The hearing is set down for October.
The Senate inquiry on Friday heard devastating evidence from many women reporting pain so extreme that even death was welcomed, and a doctor saying some mesh victims were so desperate for relief they were "at the end of the road, like cancer".
The hearing was told 90 per cent of women surveyed had not been warned of the sometimes high risk of serious pelvic mesh complications, and many women had no idea they were implanted with mesh until waking from surgery, and sometimes not until many years later.
Many women reported doctors refusing to refer them to specialists and refusing to believe their complications were linked to mesh surgery.
"Women who have gone for consultations have been scoffed at, mocked, humiliated and disregarded by some of their doctors," Australian Pelvic Mesh Support Group founder Caz Chisholm and director Stella Channing said.
"These comments are a total invalidation of a woman's lived experience. This demonstrates how the health system silences, shames and blames the victims."
The pelvic mesh inquiry was established after the support group met with Senator Derryn Hinch, who later compared mesh with the drug Thalidomide, and told federal parliament it was "one of the greatest medical scandals and abuses of mothers in Australia's history".
A first inquiry public hearing day in Melbourne was told about 150,000 mesh devices for incontinence and prolapse have been sold in Australia, all classified from medium to high risk. This includes about 30,000 of the most problematic transvaginal – surgery via the vagina – prolapse mesh devices.
At the second public hearing day in Perth on Friday doctors described some pelvic mesh devices as a "catastrophe", and were highly critical of broader issues relating to medical device safety clearance in Australia, the lack of transparency about device registration processes, and concerns about a "silent, suffering cohort" of women who lived with the consequences of failed mesh surgery.
Urogynaecologist Dr Nicolas Tsokos said the pelvic mesh scandal flowed from the "disaster that has come out of implanting things that we then can't image", after evidence from doctors and women about how some implanted mesh and anchors could not be seen in scans when complications occurred.
"You cannot keep implanting things in people without being able to find them exactly," Dr Tsokos said.
"One of my senior colleagues suggested a long time ago to the TGA (Therapeutic Goods Administration) that every device that's permanently implanted in Australia should be imageable in some fashion, and easily imageable, because otherwise the same thing's going to happen with something else."
WA Health Minister Roger Cook was strongly criticised by women for a submission saying patients undergoing pelvic mesh surgery were "apprised of all their treatment options and of the risks and evidence base in relation to the use of transvaginal mesh".
A health researcher named Daisy was scathing of the suggestion that all women had given informed consent to mesh surgery, after saying she consented to a hysterectomy in December, 2015 but woke to find she had a mesh implant "which was not consented to and not warranted".
"As a therapist and mental health professional I am aware that the most debilitating form of violence against women is perpetrated by people women trust. The fact that domestic violence is perpetrated by a woman's partner is particularly traumatising. Likewise is that perpetrated by a medical practitioner against their own patient," Daisy said.
She felt "physically sick" reading a Newcastle Herald report confirming it was tests on 13 "mongrel dogs" in Perth that initiated an Australian pelvic mesh device which went on to be registered in America, and led to the global mesh scandal.
The lack of consent by women implanted with pelvic mesh devices was a "public health outrage", she said.
"Consent is based on info question and answer, with sufficient time to consider alternatives, none of which occured in my case. This is abuse and violence against women and it's a public health outrage."
The inquiry continues.