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  Frequently Asked Questions  
  What is Stress Urinary Incontinence?  
The muscles of the pelvic floor support the bladder and usually help keep it closed or open as necessary. Stress incontinence
usually happens when these muscles become weak. So when there is sudden extra pressure (‘stress’) on your bladder, it cannot
stay closed as it should and some urine leaks out. This leakage happens during normal everyday activities, and most often when
you cough, sneeze, laugh, exercise or change position. Whether you leak a small or large amount of urine, stress incontinence
can be embarrassing and distressing. Stress incontinence can be triggered by pregnancy, childbirth or the menopause. If the
problem develops while you are pregnant or after you have a baby, it usually improves with time for most women but sometimes
it happens again later on. If you have severe stress incontinence and other treatments haven’t been effective, some women may
have to consider surgery to strengthen or tighten the tissues around your urethra.
I have a mesh tape - should I be worried?

If you are satisfied with your treatment it is not necessary to take further action. However, it is important for all patients with
a permanent mesh implant to be aware of possible related symptoms. If you are worried or experience any of the following,
please seek medical advice from your GP who can refer you to a specialist if required:

• unexplained vaginal bleeding
• pelvic or vaginal pain
• you can see or feel mesh
• return of incontinence or prolapse
• persistent urinary tract infections (UTIs)
• painful sexual intercourse (dyspareunia) – (for you or your partner)

It is advisable to have an annual check-up for peace of mind and to ensure that complications do not develop in the future.

  Treatment options for stress urinary incontinence  

Click here to view the NHS website for the treatment options.

  Further information on alternatives  

• Colposuspension - Download Patient information PDF here

Autologous Fascial Sling - Download Patient information PDF here

Bulking Agents
- Download Patient information PDF here

  Patient Information and Consent Booklet - Synthetic Vaginal Mesh Tape Procedure - Click to download  
  Questions to ask my doctor (pre-op)  
• What are the pros and cons of using mesh in my particular case?

• Could my operation be done successfully without mesh?

• What is your experience and success rate of using this particular mesh?

• What experience have your other patients had with this product?

• What is your experience of dealing with complications from this product?

• What should I expect to feel after my operation and for how long?

• Are there any specific side effects that I should let you know about after the surgery?

• What happens if the mesh doesn’t help my problem?

• If I suffer a complication, can the mesh be completely removed and what would the consequences be?

• Is there a patient information leaflet that comes with the product? Can I have a copy please?
  Who can help me? (post-op)  
It is a good idea to write down all your questions, concerns and symptoms. It may be useful to list how you believe the mesh
implant is affecting your quality of life e.g. pain, health and wellbeing, physical, marital, family, work, social etc. We are often
nervous or upset when we speak to doctors and it is easy to become distracted, a good health professional will appreciate the
fact that you have come prepared.

Please contact your GP in the first instance. He/she can assess your situation and can treat any underlying urinary tract
infection (UTI) you may have. He/she can advise and prescribe pain relief. If necessary, he/she will refer you to a specialist:
Gynaecologist, Urologist or Colorectal consultant at your local hospital.

NHS 24:
If it is out with surgery hours you can contact NHS 24 for advice. Your situation will be assessed and you will be advised accordingly. You may find just speaking to someone and listening to their suggestions - helpful and reassuring. You may be advised to contact your GP or if necessary, your local hospital Accident and Emergency department.

Mesh Helpline:
Anyone who has mesh concerns or questions regarding stress urinary incontinence or pelvic organ prolapse issues can can speak to an experienced physiotherapist who has qualifications in holistic care - in complete confidence. The mesh helpline is available on Mondays between 4.30 pm and 6.30 pm and Thursdays from 9 am to 11 am.
The helpline telephone number is: 07824537938.


Your surgeon will take a detailed history and perform an intimate examination if required. If you are in pain beforehand, please
mention this. He/she may suggest further investigations, for example MRI scan, to rule out inflammation or mass or perhaps a
cystoscopy, this is a small camera which is inserted into your bladder to make sure it is working normally and to ensure that no
mesh has eroded (broken through) into your bladder. He/she may suggest a referral to a specialist physiotherapist or pain
management clinic.

If mesh has eroded in your bladder, bowel, urethra or vagina or if the mesh implant is not where it should be or is deemed too
tight, then the surgeon will discuss your options, this is likely to include partial or complete mesh removal. At this point if it is not
offered, it is advisable that you ask to be referred to one of Scotland’s recognised mesh expert multi-disciplinary teams (MDTs)
for an additional opinion. Mesh removal can be challenging and even in experienced hands, there is no guarantee that your
symptoms will be resolved. In some cases symptoms may worsen after mesh removal.

Do your research and ask as many questions as possible. Anything you don’t understand, ask that it is explained in layman’s
terms. Read through patient information leaflets and weigh-up the pros vs cons. Do not feel under pressure to make any
decisions on the day, take time to consider all options and discuss with your family or friends. The next decision you make
could be life-changing and it is important that you are satisfied before consenting.

Questions you may want to consider asking your surgeon before mesh removal

• How many mesh removals have you done and how many have been deemed a success by your patients?

• Is partial or complete removal better in my case?

• Will partial removal need to be repeated in the future?

• Can you remove as much of the mesh implant as is safe to do so in one surgery?

• Will you remove the ends/arms of the device and what are the risks involved?

• What is the risk of nerve damage?

• Is my incontinence/prolapse likely to return and if so, can this be repaired using traditional non-mesh repairs?

• Is it true that ultrasound is the only device that shows mesh clearly?

• Do you use ultrasound to map out the mesh implant before surgery and if not why?

• How can you follow the path of a partially removed mesh implant without ultrasound to guide you?

• Will you use a camera to limit the risk of damage to my bladder or lower bowels?

• How long will my recovery be and what can I expect?

• If mesh remains inside me can I have an annual check-up to ensure that complications do not develop in the future?

• Do you send removed mesh to the lab for testing if there is infection?

• Can you preserve my removed mesh in the lab for legal purposes?

• Will you report my mesh complication/adverse incident to the Medicines and Healthcare Products Regulatory Agency (MHRA)?
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