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  6. Recommendations for Health Care Providers Treating Stress Urinary Incontinence
  1. Implants and Prosthetics

Recommendations for Health Care Providers Treating Stress Urinary Incontinence

Training

  • Obtain specialized training for each SUI mesh placement technique.

Patient Selection

  • Be vigilant for potential adverse events from the mesh sling, such as erosion.
  • Watch for complications associated with the use of the tools used in transvaginal placement of the mesh sling during the surgical procedure, such as bladder perforations.

Informing your Patient

  • Inform the patient about her choice to have incontinence repair with or without a mesh sling. The patient should understand:
    • the likely success of transvaginal SUI surgery with mesh compared to non-surgical treatment options and non-mesh surgery based on the individual patient factors.
    • the potential postoperative complications of a mesh sling surgery compared to non-mesh surgery and their effect on quality of life.
    • that there is limited information about outcomes after one year.
    • whether or not mesh will be used in the repair, and if so, which specific product will be used.
    • that a mesh sling is a permanent implant.
    • that, as with any SUI surgery, the use of surgical mesh for SUI can make any future surgical repairs more challenging and can put the patient at risk for additional complications and surgeries.
  • Ensure that the patient understands the postoperative risks and potential complications of mesh sling surgery.
  • Provide patients with a copy of the patient labeling or brochure, if available from the manufacturer

Follow-up with your patient

  • Be vigilant for potential adverse events from the mesh, especially erosion and infection.
  • Watch for complications associated with the tools used in placement, especially bowel, bladder and blood vessel perforations.
  • Submit a voluntary report about any problems experienced with surgical mesh slings through Medwatch, the FDA Safety Information and Adverse Event Reporting program