Health

Prostate Cancer Symptoms Aren’t Always Obvious

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WEDNESDAY, Sept. 20, 2017 (HealthDay News) — Although about 1 in 7 men will be eventually be diagnosed with prostate cancer in his lifetime, the warning signs of the disease are often vague and may be confused with other conditions, experts at Fox Chase Cancer Center say.

Prostate cancer can be serious but it’s often not fatal. Men should talk to their doctor about the risks and benefits of getting screened for the disease, advised Dr. Alexander Kutikov, chief of the division of urologic oncology at Fox Chase in Philadelphia.

“Considering how often prostate cancer occurs in men, every man should familiarize himself with its signs and risk factors,” Kutikov said in a center news release.

“Yet, not all men should be screened for prostate cancer. Ultimately, the decision to get screened needs to be weighed in terms of the advantages and disadvantages of screening. Men should familiarize themselves with the trade-offs of prostate cancer screening and discuss both their risk factors and personal preferences with a provider whom they trust,” he said.

Prostate cancer symptoms may be confused with signs of other common but noncancerous disorders, such as benign prostatic hyperplasia, Kutikov said.

Symptoms of prostate cancer may include:

  • Trouble starting to urinate.
  • Weak or interrupted flow of urine.
  • Urinating more often, particularly during the night.
  • Trouble emptying the bladder.
  • Pain or burning during urination.
  • Bloody urine or semen.
  • Painful ejaculation.
  • Chronic pain in the back, hips or pelvis.

Some men are at greater risk for prostate cancer. Those who are older are more likely to be diagnosed with the disease.

Prostate cancer is rare in men younger than 40 years old but once they reach 50, the risk increases. Nearly 6 out of 10 men with prostate cancer are older than 65 years old, the Fox Chase specialists said.

Black men are more likely than men of other races and ethnicities to be diagnosed with prostate cancer and die from the disease, Kutikov said. Black men are also more likely to develop advanced disease and have the condition at a younger age, he said.

Genetics may also play a role in why some men develop prostate cancer, Kutikov added. Men whose father or brother have the disease are more than twice as likely to also be diagnosed, he said. The risk increases if several family members are affected and if these men were diagnosed at a younger age.

Men who are 55 and older should discuss their risk factors for prostate cancer with their doctor and determine if screening is right for them.

“I encourage patients to educate themselves about the issue of screening, as it is quite complex,” said Kutikov.

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Weight-Loss Surgery May Leave Some Anemic

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WEDNESDAY, Sept. 20, 2017 (HealthDay News) — For many obese Americans, weight-loss surgery can be a path to losing lots of unhealthy pounds.

But new research suggests it can also lead to a long-term loss of healthy red blood cells, otherwise known as anemia.

In a study of U.S. veterans who got a common form of weight-loss (bariatric) surgery, “anemia rates are high 10 years after,” conclude a team led by Dr. Dan Eisenberg, a bariatric surgeon at Stanford School of Medicine.

One specialist who reviewed the findings wasn’t surprised.

“Anemia is a common problem in patients who have undergone gastric bypass, and this study sheds light on the severity of the problem in patients who don’t receive adequate treatment,” said Dr. Allison Barrett. She directs bariatric surgery at Long Island Jewish Forest Hill, in Forest Hill, N.Y.

She believes the research “proves that complications of surgery, such as vitamin and mineral deficiency, can also be lessened through improved follow-up.”

In the new study, Eisenberg’s team tracked outcomes for 74 older male veterans, average age 51, who underwent a common type of weight-loss surgery called Roux-en-Y gastric bypass.

The overall rate of anemia before surgery was 20 percent, the team noted, but by 10 years after surgery that number had risen to 47 percent.

Follow-up care was crucial, however. According to the study, anemia was much more common among patients who did not have close follow-up with a weight-loss surgeon. For these patients, anemia rates rose from 22 percent before surgery to 57 percent a decade later.

In comparison, for patients who did consult regularly with their weight-loss physician, anemia rates barely budged — from 13 percent before surgery to 19 percent a decade later.

According to bariatric surgeon Dr. Mitchell Roslin, that’s because simple treatments can curb the deficiencies that might occur after surgery.

“In gastric bypass, the first portion of the intestine is bypassed and iron is absorbed preferentially in that area,” explained Roslin, who directs obesity surgery at Lenox Hill Hospital in New York City.

“In general, this can be compensated for with appropriate supplements,” he said, “but patients that do not take prescribed supplements are likely to develop deficiencies.”

According to Roslin, the take-home lesson from the study is that “bariatric surgery does help [curb obesity], but patients should not believe they are cured and must be compliant and continue to follow medical direction for the duration of their life.”

The study was published Sept. 20 in the journal JAMA Surgery.

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Sterilisation implant withdrawn from non-US sale

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Essure coil implant
Image caption The coil is inserted into the fallopian tubes

Sales of a sterilisation device are being halted in all countries bar the US, weeks after the Victoria Derbyshire show reported it could cause problems.

The Essure implant, which is available on the NHS, has left some women in chronic pain, and some have even needed hysterectomies to remove it.

The pharmaceutical company Bayer said the decision to stop sales was being taken for commercial reasons.

The sale of the implants in the EU was temporarily suspended last month.

Bayer has asked hospitals in the UK not to use their existing stocks during this time.

It is a voluntary request and up to individual trusts to decide what to do.

‘Felt like a burden’

The small coil implants, which are made of nickel and polyester (PET) fibres, are used as a sterilisation device to stop eggs reaching the womb.

They are inserted into the fallopian tubes where they are designed to trigger inflammation, causing scar tissue to build up and eventually block the tubes, known as a hysteroscopic sterilisation.

Media playback is unsupported on your device
Media captionVictoria Dethier had a hysterectomy to remove the device

They can cause intense pain, and some women are thought to react badly to the nickel and plastic.

Because of the way the coils attach to the fallopian tubes, the only way to take them out is to remove a woman’s fallopian tubes and often her uterus.

In other cases the device has been found to perforate a fallopian tube and fallen out, embedding itself elsewhere in the body.

Laura Linkson, who was fitted with the Essure device in 2013, told the BBC’s Victoria Derbyshire programme the pain had left her suicidal.

Image caption Laura Linkson says she felt unable to look after her children because of the pain caused by the implant

“The device was sold to me as a simple and easy procedure. I was told that I’d be in and out of the doctor’s office in 10 minutes and that there’d be no recovery time.

“I went from being a mum who was doing everything with her children, to a mum that was stuck in bed unable to move without pain, at some points being suicidal.

“I felt like I was a burden on everyone around me,” she added.

Warning on packaging

The US is the biggest market for the product. More than 15,000 women have reported problems to the US Food and Drug Administration, which include “pain”, “allergic reactions” and the coil moving to other parts of the body.

Last year, the FDA ordered Bayer to carry out long-term testing on Essure and put a warning on its packaging.

A spokeswoman for the FDA said it was aware Bayer was no longer marketing Essure outside the US and the company had confirmed it was committed to continuing the testing as ordered.

“The FDA has taken several steps to ensure the ongoing evaluation of Essure’s safety and efficacy, as well as to educate healthcare professionals and women about the potential risks of using the device,” she said.

A statement from Bayer said: “We would like to reassure all patients, especially those with Essure, as well as health professionals, that this decision has been taken for commercial reasons and is not linked to any problems with safety or with the quality of the product.

“According to our scientific assessment, the positive risk-benefit ratio of Essure remains unchanged.

“The safety and effectiveness of Essure is supported by over 10 years of scientific research and real-life clinical experience.”

Watch the BBC’s Victoria Derbyshire programme on weekdays between 09:00 and 11:00 on BBC Two and the BBC News channel.

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Fracture Risk Higher for Seniors with Diabetes

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WEDNESDAY, Sept. 20, 2017 (HealthDay News) — Seniors with type 2 diabetes may be at increased risk for fractures. And researchers think they know why.

“Fracture in older adults with type 2 diabetes is a highly important public health problem and will only increase with the aging of the population and growing epidemic of diabetes,” said study author Dr. Elizabeth Samelson.

Samelson and her colleagues used special medical scans to assess more than 1,000 people over a three-year study period. The investigators found that older adults with type 2 diabetes had bone weakness that cannot be measured by standard bone density testing.

“Our findings identify skeletal deficits that may contribute to excess fracture risk in older adults with diabetes and may ultimately lead to new approaches to improve prevention and treatment,” said Samelson, of Hebrew SeniorLife’s Institute for Aging Research in Boston.

Fractures among seniors with osteoporosis — the age-related bone-thinning disease — are a major concern. Such fractures can lead to decreased quality of life, disability and even death, as well as significant health care costs, she said in an institute news release.

Even those with normal or higher bone density than their peers appeared to have a higher fracture risk if they had type 2 diabetes, the researchers said.

Specifically, these people had a 40 percent to 50 percent increased risk of hip fracture, the findings showed. This is considered the most serious type of osteoporosis-related fracture.

The study authors said that better understanding of the various factors that influence bone strength and fractures will aid prevention efforts.

The report was published Sept. 20 in the Journal of Bone and Mineral Research.

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Gun Surrender Laws Help Women Threatened by Domestic Violence

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WEDNESDAY, Sept. 20, 2017 (HealthDay News) — Obtaining a restraining order may not be enough to prevent domestic violence, but when state laws require the removal of firearms, risk of those violent crimes goes down, a new study says.

In states that require people with restraining orders against them to surrender their firearms, the intimate partner murder rate dropped by 10 percent. In states that don’t require surrender, the rate went down less than 7 percent, the study found.

And the rate of these firearm-related crimes fell 15 percent in states that require surrender, researchers said.

But, just as laws restricting firearm surrender vary from state to state — some have “possession” laws while others have “surrender” laws — the protection for victims isn’t always the same.

“Most of the prior research on this topic that have looked at gun laws looks just at whether states have or don’t have a particular law,” explained study author Dr. Michael Siegel, professor of community health sciences at Boston University School of Public Health.

“But we wanted to do a much more detailed coding of the laws so that we could get into the fine details, such as not only is there a law that prohibits firearm possession, but whether they are actually required to surrender the guns,” he said.

Currently, more than 1,800 people die from domestic violence in the United States every year. About half of these homicides are committed with firearms. Approximately 85 percent of victims are women.

In 1994, a federal law barred firearm possession if someone was accused of intimate partner violence. But the federal government is limited in its ability to enforce the law. States had to develop their own laws based on these federal guidelines, the study noted.

“We found that simply passing a law saying that people who are subject to domestic violence restraining orders cannot possess a firearm really didn’t have an impact on rates of intimate partner homicide,” Siegel explained.

“However, if the state also required that people subject to those requirements surrender the weapons that they already have, then we found a very large and significant impact on decreasing intimate partner homicide rates,” he said.

The study concluded that of the states with surrender laws, the rates of intimate partner homicide dropped significantly compared to states where no law was passed.

But, according to Siegel, it’s not simply about passing a law, it’s also about enforcement.

“We shouldn’t just rely on people proactively walking into a police department and saying, ‘Oh, here, I was just issued a restraining order and I wanted to be proactive and give you all of my guns,'” Siegel said.

He suggested that enforcement mechanisms must be put in place to guarantee that firearms are removed.

Some states, Siegel said, do this better than others.

Police Chief David Ryan from Pound Ridge, N.Y., said, “Even though there are loopholes in the federal guidelines, with every order of protection that we receive, we insist on a surrender of all weapons.

“We don’t care what the circumstances are, whatever the violation is, whether it’s federal court, civil court or criminal court, I insist on the surrender. And, because there are loopholes in the federal law, once I have them, I’m not giving them back.”

In states that have surrender laws, the researcher’s models for 2015 suggest that there were 75 fewer homicides linked to domestic violence than were expected.

If all states had these laws in place, there would have been an additional 120 fewer intimate partner homicides across the nation in 2015, the researchers said.

Ryan explained that it’s important to have a lethality assessment for getting a restraining order with firearm surrender.

“You can do that if you can show the violent behavior at whatever level it is — physical, psychological or verbal, along with what I call contributing factors, such as mental health issues, substance abuse, losing a job or a prior conviction of a crime,” he said.

Siegel hopes that this study will encourage other states’ policymakers and law enforcement to pass and enforce these laws in a similar manner.

The study was published Sept. 18 in the Annals of Internal Medicine .

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Anger as Brazilian judge backs anti-gay ‘therapy’

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Revellers march with a giant rainbow flag during the annual Gay Pride Parade at Copacabana beach in Rio de Janeiro, BrazilImage copyrightYASUYOSHI CHIBA/AFP/Getty Images
Image caption Rio de Janeiro has a thriving gay scene – and the community is aghast after a judge approved controversial “conversion therapy”

Brazilian activists and celebrities have condemned a court ruling that approves a “cure” for gay people.

Waldemar de Carvalho, a federal judge in the capital Brasilia, backed a psychologist who had her licence revoked for offering so-called “conversion therapy”.

Rozangela Justino is an evangelical Christian who has called homosexuality “a disease”.

Critics have called the ruling regressive and medically unsound.

Brazil’s Federal Council of Psychology banned psychologists from offering treatments that claim to change people’s sexuality in 1999.

It said in a statement that the decision “opens the dangerous possibility of the use of sexual reversion therapies” and promised to fight it in court.

Prominent pop star Anitta shared her disgust in an online video, which has been watched by over a million people.

“That’s what happens in my country. People dying, hungry, the government killing the country with corruption, no education, no hospitals, no opportunities… and the authorities are wasting their time to announce that homosexuality is a sickness,” she said.

Image copyrightInstagram/Anitta

Ivete Sangolo, another of Brazil’s most popular singers, wrote on Instagram: “The sick ones are those who believe in this great absurdity.”

Her post has been liked over 236,000 times since it was posted a day ago.

On Twitter, many users shared support for the gay community, posting pictures and cartoons condemning the verdict.

“Of course, because in this country it is more important to ‘cure’ human sexuality than to treat prejudice,” one man wrote in Portuguese.

“There’s no cure for what is not a disease,” others tweeted, using the hashtag #curagay (“gay cure”).

That view was shared by Rogério Giannini, head of the Federal Council of Psychology, who told the UK’s Guardian newspaper there was no medical basis for the alleged therapy.

“It is not a serious, academic debate, it is a debate connected to religious or conservative positions,” he said.

Skip Twitter post by @betoperazzo

“There’s no cure for what is not a disease.” #against#curagaypic.twitter.com/7L9jjf9O0f

— Beto Perazzo (@betoperazzo) September 19, 2017

End of Twitter post by @betoperazzo

Brazil is seeing growing push-back from conservative Christians over progressive policies which they see as an affront to traditional values.

They have protested against gay characters in TV soap operas, and got an art exhibition on gender and sexual diversity shut down last week.

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MMR vaccine first-dose target met in England

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Syringe in a medical centreImage copyrightPA

The percentage of children getting their first dose of the measles, mumps and rubella vaccine (MMR) by their fifth birthday has reached 95% for the first time, NHS data shows.

This meets a World Health Organization target. Coverage has been increasing in England for the past 10 years.

The NHS says children should have two doses of the vaccine before starting school.

But only 87.6% had received both doses by their fifth birthday.

The MMR vaccine is given on the NHS as a single injection to babies as part of their routine vaccination schedule, usually within a month of their first birthday.

They should then have a second injection of the vaccine before starting school, usually at three years and four months.

Figures published by NHS Digital show that coverage of the first MMR vaccine by the age of five was 85.9% in 2006-07, rising every year to 95% in 2016-17.

However, the percentage of children being vaccinated with the first dose by their second birthday has gone down for the third year in a row, to 91.6%.

MMR vaccination rates dipped after a panic caused by discredited former doctor Andrew Wakefield, who falsely claimed in the late 1990s that the jab caused autism.

Dr Mary Ramsay, head of immunisations at Public Health England, said: “England is considered to be a world leader in childhood vaccination, with one of the most comprehensive programmes in the world.

“As we are seeing small reductions in coverage for most other childhood vaccines, measured at 12 months in recent years, we continue to encourage all parents to get the best protection for their children by ensuring they are fully immunised with all their childhood jabs.

She added: “We are working closely with the NHS, and with staff in general practice where most vaccinations are delivered, to improve uptake.”

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Quarter of 14-year-old girls ‘have signs of depression’

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Catherine Perrin-GriffithsImage copyrightCatherine Perrin-Griffiths

A quarter of girls and nearly one in 10 boys show signs of depression at the age of 14, say UK researchers.

The government-funded study of over 10,000 young people looked at how many experienced the signs of depression not a clinical diagnosis of one.

Being from a poorer background or being of mixed or white ethnic background appeared to raise the risk.

Surveys with their parents, however, suggested many were not attuned to the true anxieties of their children.

Parents often underestimated daughters’ stress and had concerns about sons that the boys themselves did not voice.

Lead investigator Dr Praveetha Patalay, from Liverpool University, said teenagers, and particularly girls, were facing more mental health difficulties than previous generations – although the study did not look at this.

Image copyrightGetty Images

Many factors could be contributing, including exam stress and worries about body image, experts believe.

However, the rise could also be down to a greater willingness to acknowledge mental health problems by society.

The Millennium Cohort Study survey suggests:

  • Teenage girls report more anxiety and depressive symptoms than boys
  • 14-year-olds from poorer socioeconomic backgrounds are more likely to report depressive symptoms than peers from better-off families
  • Girls from mixed and white ethnic backgrounds are the most likely to report high depressive symptoms
  • Black African girls are least likely to report high depressive symptoms at this age
  • For boys, those from mixed and other ethnic groups are at greatest risk of depressive symptoms
  • Bangladeshi and Indian boys are the least likely to report these symptoms
  • Agreement between self- and parent-reported emotional symptoms of 14-year-olds is weak

Half of all cases of adult mental illness start by the age of 14, and it is important they are diagnosed and treated early.

Cat Perrin is a student nurse and has had mental health problems since her teenage years.

“When I was 14 I was really low, a bit hopeless… I kind of isolated myself a bit.

“I felt constant pressure to be better than I was. I got really down and anxious.

“I got a bit scared to leave the house and a bit scared to speak to people.”

When she was 15, she was told she had anxiety and depression but it took until she was 18 for her to seek help.

Eventually Cat’s mental health improved, after she became an in-patient, but she wishes she had asked for help sooner.

She believes teenagers are struggling with mental health issues because of the influence of social media.

“There’s this constant pressure to see how many people are better or prettier than you.

“There is pressure to do well at school, get a good job, be financially stable – but at the end of the day, they’re just children.”

Demand for specialist services is growing, but child and adolescent mental health teams are overstretched and turn away nearly a quarter of the young patients referred to them, says the National Children’s Bureau, which has published the survey findings.

Its chief executive, Anna Feuchtwang, said: “With a quarter of 14-year-old girls showing signs of depression, it’s now beyond doubt that this problem is reaching crisis point.

“Worryingly, there is evidence that parents may be underestimating their daughters’ mental health needs.

“Conversely, parents may be picking up on symptoms in their sons, which boys don’t report themselves.

“It’s vital that both children and their parents can make their voices heard to maximise the chances of early identification and access to specialist support.”

Dr Marc Bush, from the charity Young Minds, said: “We know that teenage girls face a huge range of pressures, including stress at school, body image issues, bullying and the pressure created by social media.

“Difficult experiences in childhood, including bereavement, domestic violence or neglect, can also have a serious impact, often several years down the line.

“To make matters worse, it can be extremely difficult for teenagers to get the right support if they’re struggling to cope.

“That’s why it’s crucial that mental health services are properly funded, with a focus on early intervention.”

Signs of depression

  • continuous low mood or sadness
  • feeling hopeless and helpless
  • having low self-esteem
  • feeling tearful
  • feeling guilt-ridden
  • feeling irritable and intolerant of others
  • having no motivation or interest in things
  • finding it difficult to make decisions
  • not getting any enjoyment out of life
  • feeling anxious or worried
  • having suicidal thoughts or thoughts of self-harming
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Hernia mesh surgery leaves men in pain

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Hernia meshImage copyrightGetty Images
Image caption Mesh is the NHS’s ‘recommended method’ for treating groin hernias

A group of men have said they have been left in chronic pain and made to feel hopeless after having mesh inserted during surgery for hernias.

The men, who have formed a self-help group in Northern Ireland, are calling for a suspension of the material’s use until more is known about it.

The Shadow Northern Ireland secretary, Owen Smith, has told BBC News NI he believes the mesh issue will become one of the biggest health scares in the UK.

But the Department of Health has said it was confining its work to complaints made only by women.

Speaking to the BBC, the men said they felt their complaints should be taken into consideration as well.

‘I have no private life’

For the majority, hernia operations are successful, but they can leave patients in chronic pain.

Roy Morrison said the pain around his testicles was almost constant.

“Think of when a sports man gets kicked in the groin area and falls to the ground in pain,” he said. “That’s what my pain can be like.”


Mesh for treating groin hernias

The material is the NHS’s “recommended method” for treating hernias, and is used on tens of thousands of patients every year.

A hernia occurs when an organ or fatty tissue pokes through a gap where muscle has weakened. It most commonly takes place in the groin.

The use of mesh involves pushing bulging tissue back into the abdomen and covering it with the material, and can be delivered via open or keyhole surgery.

One in 10 people will develop a hernia, and some experts are concerned about the “thousands of hernia mesh patients who are living with chronic pain”.

According to NHS Choices, 10% of hernias come back at some point after surgery.

The Royal College of Surgeons said while “any poor outcomes are regrettable”, mesh implants were the “most effective” way to deal with a hernia.


Image caption Roy Morrison has spent £5,000 in private clinics trying to find out what is causing his pain

Mr Morrison had mesh inserted during a hernia procedure 14 years ago and has set up the local Facebook group.

He has spent some £5,000 in private clinics trying to find out what is causing his pain.

“The whole time I went to see medical people in the health trusts and because this is not in the medical text books they say it can’t be real,” he said.

“They just don’t believe you and you are left with a feeling of just hopelessness – and that is very painful too. ”

Image caption The men who have formed a self-help group in Northern Ireland are calling for a suspension of the material’s use until more is known about it

Members of the men’s group said they were prepared to reveal personal details as they want other men to come forward and talk about their condition and receive help.

Damien Murtagh, who lives in Banbridge, has been left with a limp as a result of his operation four years ago.

“For years no one could tell me what is causing this pain,” he said.

“I can no longer ride my bike, go fishing, I work part-time,” he said.

“The pain in the lower stomach and groin area makes me feel physically sick. I have no private life. ”

Image caption Damien Murtagh has had a limp since his operation four years ago

Earlier this year local women broke their silence over problems around vaginal mesh.

Now, men are going public following problems with mesh used in hernia operations.

They feel they are being passed from pillar-to-post as no one knows how to deal with their complaints.

Sean McGrath had a hernia operation in 2016, and said he would have thought twice about having the procedure had he been given any warning about potential complications.

“I was told that six weeks after the operation I would be back to normal, back to work, walking and cycling,” said the 52-year-old from Newry.

“That’s not the case. I am married and my personal life is affected too.

“I just want it fixed.”

Image caption Sean McGrath said he was given no warning about potential complications

The Department of Health and the Public Health Agency have recently begun work involving medical consultants on the mesh issue.

In a statement the Department said a recent clinical workshop set out the next steps in developing a standard approach throughout Northern Ireland in managing women with these conditions.

“Mesh surgery has its place in the treatment of these conditions where individual women are appropriately assessed and choose the procedure having been advised of the risks and benefits,” it said.

Meanwhile, an all-party parliamentary group has been set up by Owen Smith, who said he was shocked by the stories he had heard.

He said it is crucial that local MPs join the group so they can represent the interests of men and women living in Northern Ireland.

“It’s going to be much bigger than the breast implant scare because 100,000 women, give or take, have had mesh implants across the UK,” he said.

“The rate of adverse events is much higher than what we appreciated.

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