Urinary incontinence is a common condition, especially in older adults. In fact, about 13 million Americans experience incontinence; 85 percent of people experiencing this bladder control problem are women.
A person with urinary incontinence leaks urine by accident. People with urinary incontinence often have sudden, urgent urge to urinate, followed by an involuntary loss of urine. Severity of urinary incontinence ranges from a small leak when coughing or sneezing to an urge to urinate so sudden and strong that there is no time to find a toilet.
Also known as overactive bladder, urinary incontinence can be embarrassing and interfere with a person’s normal activities. Urinary incontinence may create a need to urinate more frequently; many people have to plan their lives around finding a bathroom, avoiding food, drinks and activities that increase the need for urination, and buying pad and other products to control leaking. Urinary incontinence can even increase the risk for falls in older adults as they rush to the toilet.
Treatment for Urinary Incontinence with Mesh Implants
People with urinary incontinence often go to great lengths to avoid embarrassing leaks associated with urinary incontinence. When urinary incontinence gets out of control, they seek medical help to determine the underlying cause of bladder leaks and find a solution.
Doctors often recommend starting with less invasive techniques, such as bladder training, scheduled toilet trips, fluid and diet management, and pelvic floor muscle exercises, also known as Kegel exercises. Some patients go as far as electrical stimulation, Botox injections, and the insertion of medical devices to suppress urinary leakage. If these treatments fail to control urinary incontinence, a doctor may recommend surgery, such as the insertion of a mesh implant.
As its name suggests, a mesh implant is a screen-like material that reinforces tissue. Mesh implants may be made of man-made synthetic polymers or biopolymers produced or derived from living organisms.
Surgical mesh may be made from:
- Non-absorbable synthetic polymers, or polypropylene
- Absorbable synthetic polymers, such as polyglycolic acid or polycaprolactone
- Biologic biopolymers, including acellular collagen sourced from pigs or cows
- Composite that combines any of the three materials listed above
A mesh implant creates a support structure to the bladder and urethra. The bladder holds urine, while the urethra carries urine to the outside of the body. A group of muscles make up the bladder neck to connect the bladder and the urethra. These muscles tighten to keep urine in the bladder and relax to release urine into the urethra. Urinary incontinence can develop when the muscles of the bladder neck do not work as they should, and allow urine to leak from the bladder into the urethra.
Surgeons may recommend a sling procedure to correct urinary incontinence. The surgeon uses the synthetic mesh to create a sling underneath the urethra and bladder neck. This sling helps keep the urethra closed, especially when the patient sneezes or coughs.
Complications may affect the mesh implants. These complications include:
- Erosion of the mesh implant following sling surgery
- Trouble urinating
- Recurrent urinary tract infections (UTIs)
- Fistula, or opening
- Organ perforation
- Neuromuscular changes
- lower urinary tract symptoms
- Bowel complications
- Immune disorders
Complications may require the removal of the mesh implant. In fact, between 2.3 and 6.1 of women who have mesh implant complications require medical intervention.