The Australasian Pelvic Floor Procedure Registry (APFPR) is a Commonwealth Government health initiative established to record information about surgeries for stress urinary incontinence (SUI) and pelvic organ prolapse (POP) procedures. It is a clinician-led national clinical quality registry managed by Monash University. This registry was established following a Senate Inquiry where brave Australians who suffered deeply private and frequently traumatic experiences as a result of mesh-related procedures shared stories that prompted important changes to our nation’s health system. The APFPR is a part of a broader response by the Commonwealth and State governments to support mesh-affected women. This registry is an outcome of their efforts, ensuring that complications associated with pelvic floor procedures involving mesh are monitored for safety and quality of care. The APFPR has consumer representation to ensure that the aims and activities of the registry is informed by the experiences and advice of women who live with mesh complications. The project is being managed by the Clinical Outcomes data Reporting and Research Program part of Public Health and Preventive Medicine, Monash University. The APFPR is supported by funding from the Australian Government Department of Health.
The APFPR captures data pertaining to the following procedures:
Stress Urinary Incontinence
- Mid urethral Sling (synthetic mesh)
- Peri-urethral Bulking agent
- Bulking agent removal
- SUI mesh revision/explantation
Pelvic Organ Prolapse procedures
- Sacrocolpopexy with mesh
- Sacrohysteropexy with mesh
- Anterior repair with mesh
- Posterior repair with mesh
- POP mesh revision/explantation
Each year thousands of Australian women undergo pelvic floor reconstructive surgical procedure to treat stress urinary incontinence (SUI) and pelvic organ prolapse (POP). Approximately one quarter of these procedures involve the use of a surgical mesh product, with an estimated 150,000 mesh devices being implanted since 1998. As reported by the 2018 Senate Community Affairs Reference Committee Inquiry into the Number of women in Australia who have had transvaginal mesh implants and related matters, some women undergoing a mesh procedure suffered significant and devastating adverse events that were life-altering, however the Inquiry revealed it was difficult to ascertain just how many had undergone the procedure because of limited existing clinical data reporting systems for pelvic mesh.
Following the Inquiry, the Senate Committee made 13 recommendations related to the establishment of a system for monitoring and reporting the number of devices implanted and patient outcomes including complications and adverse events. Specifically, it recommended the implementation of a registry for all high-risk implantable devices. In April 2019 the Health Minister announced the Commonwealth Government would provide $2.3 million over three years to establish the APFPR to collect information about the safety of medical procedures and transvaginal surgical mesh devices which are used in the treatment of pelvic organ prolapse (POP) and stress urinary incontinence (SUI).