Transvaginal mesh short-life working group: report

Appendix Two: Glossary of terms

Accountable Officer

The Accountable Officer is responsible for ensuring that the required high vigilance measures are followed in every case. The affirming clinician should be independent of the patient's clinical care and need not be of that clinical specialty.

AHPs

Allied Health Professionals are a distinct group of professionals who apply their expertise to diagnose, treat and rehabilitate and include Specialist Physiotherapists

Autologous Fascial sling

A surgical procedure to treat stress incontinence, involving placement of fascia (strong tendineous material from the body) under the weak urethra to provide support to the urethra during periods of increased pressure on the bladder such as running, coughing, or laughing.

BAUS

The British Association of Urological Surgeons exists to promote the highest standards of practice in urology

BSUG

The British Society of Urogynaecology (BSUG) aims to set and raise standards in Urogynaecology

Decision aids

Decision aids are interventions or tools designed to facilitate shared decision making and patient participation in health care decisions.

EC4H

Effective Communication for Healthcare (EC4H) provides courses which allow staff to reflect on their communication style. Clinical staff support tutor training, new courses, educational materials and a network of trainers so that the quality of the courses is maintained.

High Vigilance Scrutiny

Process of assurance for the care of women undergoing surgery for stress urinary incontinence and pelvic organ prolapse. The process includes:

• Assurance of competence
• Documentation of the decision making process
• Documentation and registration of all procedures on an agreed database
• Documentation of all mesh and non-mesh related complications on the database (above) and reporting of mesh related complications to Health Facilities Scotland Incident Reporting and Investigation Centre (IRIC)
• Documentation given to every patient treated with mesh detailing their procedure, the mesh or other product used (including product codes) and the name of the surgeon.

IRIC

The Incident Reporting and Investigation Centre (IRIC) is a specialist safety and risk management unit dealing with medical devices, estates & facilities, and social care equipment in Scotland.

Laparoscopic Colposuspension

A surgical procedure to treat SUI carried out through one or more small incisions using special, small surgical instruments, to lift up the neck of the bladder, and stitch it in this position.

MDT

The multidisciplinary team (MDT) is a team of professionals including representatives of different disciplines who coordinate the contributions of each profession, which are not considered to overlap, in order to improve patient care

Mentorship scheme

This BSUG scheme is designed to guide training in non-mesh continence surgery, namely colposuspension and/or autologous fascial sling for consultant gynaecologists who wish to (re)introduce one or both of these procedures into their practice for primary stress urinary incontinence.

MHRA

The Medicines and Healthcare products Regulatory Agency (MHRA) regulates medicines, medical devices and blood components for transfusion in the UK

NICE

The National Institute for Health and Care Excellence (NICE) provides national guidance and advice to improve health and social care in England and Wales

Open colposuspension

A surgical procedure to treat SUI, involving a large incision in the lower abdomen, to lift up the neck of the bladder, and stitch it in this position.

Pelvic organ prolapse (POP)

Bulging of one or more of the pelvic organs into the vagina

Specialist physiotherapy

Physiotherapists who specialise in the assessment, diagnosis and treatment of a range of conditions including bladder and bowel dysfunction and pelvic organ prolapse

Stress urinary incontinence (SUI)

Involuntary loss of urine during coughing, sneezing or physical exertion such as sports activities

Transvaginal mesh

A permanent implant usually made from the non-absorbable polypropylene material, surgically placed via the vagina to support the urethra