Mesh
Saint Mary's Hospital
Mesh at Saint Mary's Hospital
The Manchester Mesh Complications Specialist Service at Saint Mary's Hospital is one of nine specialist Mesh Complication Centres in England. Based in the Warrell Unit, the service has over 10 years' experience supporting women with mesh complications following surgery for urinary incontinence and vaginal prolapse.
Observers and fellows will experience a specialist multidisciplinary service providing assessment, investigation, surgical treatment and non-surgical treatment for complex mesh-related symptoms. Referrals are received from the North West region, Wales and other UK regions.
The service is led by Dr Karen Ward, Consultant Gynaecologist and Clinical Lead for the North-West Mesh Complications Service. The wider team includes urogynaecology surgeons, specialist nurses, imaging specialists, pain management, physiotherapy, psychology, psychosexual therapy and pathway coordination.
The programme sits within the wider urogynaecology service at Saint Mary's Hospital, which investigates and treats bladder problems, vaginal prolapse and bowel control problems, with clinics held in the Warrell Unit and surgical admissions to Ward 62.
Fellowships and observerships at Manchester Specialist Health Academy provide international clinicians with structured opportunities to experience high quality healthcare training within a leading NHS environment. Both pathways offer consultant oversight, a clear induction, and access to modern clinical settings that support a strong understanding of advanced patient care. Participants are welcomed into a professional community that encourages learning, collaboration, and engagement with the culture of Manchester.
While fellows take part in more in depth clinical development, gaining exposure to subspecialties, procedures and research, observers focus on shadowing and understanding multidisciplinary practice within NHS services. Both groups benefit from involvement in clinics, team discussions, and wider learning activities such as simulation sessions, CPD opportunities, and quality improvement insight.
Academic contributions and awards
Abbas N and Reid F. The management of mesh complications. Obstetrics Gynaecology & Reproductive Medicine. 2022; 32(11):247-52. DOI: 10.1016/j.ogrm.2022.08.006
Abbas N, Virdee T, Basu M, Iles D, Kanitkar S, Kearney R, Ward K et al. Clinical outcomes after total excision of transobturator tape inserted for treatment of stress urinary incontinence. Neurourol Urodyn. 2023;42(4):785-93. https://doi.org/10.1002/nau.25155
Carter P, Fou L, Whiter F, Delgado Nunes V, Hasler E, Austin C, Macbeth F, Ward K, Kearney R. Management of mesh complications following surgery for stress urinary incontinence or pelvic organ prolapse: a systematic review. BJOG. 2020;127(1):28-35. https://doi.org/10.1111/1471-0528.15958
Mahoney, Charlotte ; Hindle, Adam ; Rajashanker, Balashanmugam et al. / MR scan evaluation of pelvic organ prolapse mesh complications and agreement with intra-operative findings. In: International Urogynecology Journal. 2019 ; Vol. 31, No. 8. pp. 1559-1566. https://link.springer.com/article/10.1007/s00192-019-04182-7
Rare and complex cases
Observers and fellows may observe mesh complications after surgery for stress urinary incontinence or pelvic organ prolapse, including pain, exposure, urinary symptoms, prolapse symptoms, bowel-related symptoms and complex pelvic floor dysfunction.
The observership or fellowship provides exposure to multidisciplinary assessment of complex cases involving urogynaecology, urology, colorectal surgery, radiology, pain medicine, physiotherapy, psychology, psychosexual therapy, clinical nurse specialists and MDT coordination.
Learning themes include the assessment of previous mesh surgery, use of questionnaires, diagnostic investigations, imaging review, patient-centred discussion of treatment options, MDT decision-making, and planning for surgical or non-surgical management.
Why Manchester?
Manchester is a city of innovation and progress, renowned as the world’s first industrial city and still leading in science, healthcare, and technology. With excellent transport links and a vibrant, multicultural atmosphere, it offers an inclusive environment for learning and professional growth.
Beyond your placement, Manchester offers something for everyone - from watching the iconic Manchester derby to exploring world-class museums and galleries. With vibrant music, sport, and culture, the city truly has it all. Combining heritage and modernity, it creates a unique setting for personal enrichment and memorable experiences whilst you develop professionally.
Our signature programmes
Observership
Mesh
Objectives
By the end of the placement, the visiting professional should be able to:
- Describe the structure of a specialist mesh complications service within a tertiary urogynaecology setting.
- Observe multidisciplinary assessment of women with mesh complications after surgery for urinary incontinence or vaginal prolapse.
- Understand how questionnaires, clinical assessment, diagnostic testing, imaging and MDT review support management planning.
- Recognise the roles of urogynaecology, urology, colorectal surgery, radiology, pain medicine, physiotherapy, psychology, psychosexual therapy, specialist nursing and coordination in complex pelvic floor care.
- Observe how surgical and non-surgical treatment options are discussed and agreed with women following assessment and MDT review.
- Understand how research, guidelines, patient decision aids and specialist centre working support safe mesh complication care.
Eligibility
- The visiting professional must have sufficient English language skills to engage meaningfully in the observership.
Fellowship
Mesh
Objectives
By the end of the placement, the visiting professional should be able to:
- Apply supervised clinical reasoning to the assessment and management planning of mesh-related complications within a specialist urogynaecology service.
- Contribute to supervised assessment, investigation planning, MDT preparation and pathway coordination for women with complex pelvic floor symptoms.
- Develop practical understanding of pelvic floor investigations, imaging review, surgical planning, non-surgical management and follow-up pathways.
- Strengthen multidisciplinary communication with urogynaecology surgeons, nurses, radiologists, pain specialists, physiotherapists, psychologists, psychosexual therapists, urologists and colorectal surgeons.
- Engage with clinical governance, research, audit, education or service improvement activity.
- Reflect on transferable approaches to complex pelvic floor care, shared decision-making, specialist centre models and future service leadership.
Eligibility
- Postgraduate Qualification: Applicants must hold an overseas-recognised postgraduate medical qualification (MD, MS, Masters) in ophthalmology or a relevant specialty.
- Experience: Minimum of 3 years’ recent experience in ophthalmology or a related specialty within the last 5 years, including at least 12 months of continuous practice before applying.
- Training Level: Equivalent to ST5 or above, or post-CCT clinicians seeking subspecialty exposure.
- Language Proficiency: IELTS Academic with 7.0 in each band and overall 7.5, or OET Medicine with Grade B in all domains, with certificate validity within 24 months.
- Registration: GMC registration is required for fellowship activity. Sponsorship support may be available through approved routes where appropriate.
- Applicants must not have failed PLAB exams previously.
- Visa sponsorship is only available through approved routes; self-funded visas outside agreed schemes are excluded.