CONCERNS that women are being put forward for potentially risky surgery when they could have been helped by a physiotherapist are being raised.
The harrowing stories of women who have suffered complications following mesh implants has triggered a new campaign for all patients to be offered specialist physiotherapy care before they see an operating theatre.
However, the Chartered Society of Physiotherapy is warning waiting times to see a physio who specialises in pelvic health already range from eight to 35 weeks.
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They say there have been cases of patients who went for mesh implant procedures because the appointment came through before they had had the chance to see the physiotherapist.
Kenryck Lloyd-Jones, policy manager for the Chartered Society of Physiotherapy Scotland, said: "The Scottish mesh survivors have highlighted the scandal of undergoing surgery without knowing the potential risks.
"However, beneath this scandal is the scandal about women not having the chance to see a physiotherapist which may eliminate the need for surgery."
Mesh implants are used to treat problems such as leaking urine - a condition which affects as many as one in three women - and is more likely after childbirth.
Last year the Scottish Mesh Survivors group's Hear Our Voice campaign lodged a petition in the Scottish Parliament calling for an end to their use, describing how patients who had had the implants had been left with long term complications and pain.
Earlier this month Shona Robison, Scottish Health Secretary, asked for all health boards to be sent a letter again urging them to suspend the use of the implants until an independent review of their use has been published.
However, as the implants are not banned by the Medicine and Healthcare products Regulatory Agency (MHRA), patients can still request them.
Mr Lloyd-Jones said specialist physiotherapists could work with patients to strengthen their pelvic floor and eliminate the need for surgery. These staff have expert training in this area and can use a range of equipment to ensure women perform the exercises properly.
However, he said there were only 40 specialists for the whole of Scotland and staff who wanted to work in this field had to pay for their own training.
Irene Pullar, an advanced physiotherapy practitioner in pelvic floor dysfunction in Tayside, said around 80 per cent of the women seen in her service did not require any further treatment.
She added: "Simple advice works very well for a lot of women, but there are women who bypass that completely because there are some areas that do not have women health physios."
Ms Pullar said her service had a waiting list of 150 women and was seeing people within two or three months.
Nikki Lawrence was given an implant when she was 31. After two difficult pregnancies, she said she needed surgery because her bowel had moved and was also suffering some stress incontinence.
Since her operation she has endured excruciating pain in her pelvis and her hips. "I need crutches to walk. It has ruined five years of my life and my kids' life as well," she said.
Ms Lawrence, from Stonehaven, said she was never offered physiotherapy as an alternative to surgery and now wonders whether she really needed the procedure at all.
"I understand that physiotherapy can take a longer time to get the end result, but if the end result is that you are better and you have no pain, it can only be a good thing," she said.
The Chartered Society of Physiotherapy Scotland is calling for all women to be referred for physiotherapy before they are sent for surgery.
They want training to be funded to increase the number of staff in the field and a review of current capacity. They also want women to be able to refer themselves directly for pelvic floor physiotherapy rather than going through a GP.
The Scottish Government said: "Referral for specialist physiotherapy should be considered for all women with incontinence and prolapse, prior to a decision being made to intervene surgically. Physiotherapy can be very helpful and may provide an alternative to surgery for some women.
"Since 2007 the number of physiotherapists working in the NHS has increased nearly 10 per cent, and we expect health boards to have the correct staff in place to meet the needs of the service and ensure high quality patient care.
"The Scottish Government is working with health boards to make sure that all boards follow guidance on the management of these conditions. A protocol is being developed to aid this process."