Treating Incontinence: From Vaginal Mesh to Non-Vaginal Options

Experiencing an occasional leak when you laugh, sneeze or exercise? Unfortunately for many of us, those occasional leaks persist and only get worse with time.  Soon you may find yourself not just dealing with occasional leaks, but having to wear bulky pads during the day to hide your leaks.  You may even start modifying your activity to avoid situations that could lead to an embarrassing accident. We have to pay attention to our bodies and get the treatment we need when we need it­. Unfortunately, as symptoms progress, there are fewer treatment options.  But please know that incontinence is treatable, not just a natural development we have to accept as we age. 

Leaking when you laugh, cough, sneeze, exercise, or move is called stress incontinence.  As we age or following the birth of a child, our pelvic floor muscles may weaken, and become stressed to the point that they cannot stop urine from leaking out. Your doctor may recommend that you do Kegel exercises multiple times per day to strengthen your pelvic floor, which is a great idea. But with our fast-paced lives, it can be hard to remember to do them consistently, and as many as 25% of women aren’t even doing them correctly. That’s a lot of us, so you’re not alone if you’re in this boat.

Vaginal Mesh for Incontinence Treatment

In searching for alternative treatments you’ve likely read about surgical procedures that involve implanting a “vaginal mesh” (sometimes called ‘tape’).  The mesh is typically inserted through the wall of the vagina and positioned in different ways to support the urethra and other pelvic organs. These procedures can work well, and for some women, it’s the only real solution for their severe symptoms. However, there is growing evidence that for many women the risks may not outweigh the benefits. These risks include chronic urinary tract infection, unrelenting pain, and even difficulty walking. Sometimes the plastic implant erodes through the vaginal wall, and other times the plastic becomes brittle and breaks, leaving many small fragments. When this happens, the surgery to remove the mesh and correct the problem is difficult, painful, and very expensive. 

Regulatory agencies have taken notice.  In some countries, including Australia and the UK, the use of these meshes has been severely limited or outright banned.  Earlier this year, the US FDA took meshes used to repair pelvic organ prolapse off the market, while similar meshes used solely to treat incontinence (i.e. without pelvic organ prolapse) have been allowed to remain for sale. The medical community is continuing to collect information to better understand the safe use of these products.

Conservative Incontinence Treatments to Consider

Thankfully, for many women dealing with incontinence, there are more conservative treatment options to consider before surgery involving vaginal mesh.  Remember, each of these is most effective if you start treatment before your symptoms become severe.  Be proactive about your pelvic floor health, and don’t wait until surgery is your only treatment option.

Like with so many health issues, weight loss and exercise are great first steps toward improving your continence.  Other potentially helpful lifestyle changes include monitoring your fluid intake, quitting smoking (good for so many reasons), and cutting down on caffeine and alcohol use.  As stated previously, Kegel exercises are very for some women.  If you’re not sure whether you’re doing them correctly you may want to visit a pelvic floor physical therapist.  These specialists can teach you proper technique and perform other internal and external treatments to improve your pelvic floor function.  This may include techniques that use vaginally inserted probes to either monitor your muscle contractions or deliver electrical stimulation to contract the muscles for you.  These treatments can be highly effective, but some women aren’t comfortable having a device inserted vaginally. 

New Non-Vaginal Incontinence Treatments

The FDA recently created a product code for incontinence devices that deliver treatment through the skin, without vaginal insertion.  If you are someone who prefers a non-invasive option, a new device called ELITONE® could work for you. This device uses gentle electrical pulses to exercise the muscles of your pelvic floor during short 20 minutes treatments. ELITONE does the Kegel exercises for you, but longer and stronger than what you could do no your own. This makes treatment super convenient for busy women who aren’t able to schedule weekly physical therapy appointments.  The device is also discreet (thinner than a pad), so you can wear it under your clothes and get other things done while you receive treatment. A much better option than having a vaginal mesh implant, right?!

Remember, you have treatment options beyond surgery, but “doing nothing” is clearly not a good choice. Before your incontinence gets too severe, research your options, speak with a healthcare professional, and choose a solution that works best for you.