01 March 2018

Women are opting out of incontinence surgery for this scary reason

Bad press and misinformation is making incontinence surgery difficult for doctors to perform.


Incontinence sufferers (i.e., having leakage that occurs when you run, cough, sneeze or laugh) are dealing with fears way beyond Googling your nausea symptoms and concluding that you’re dying from Listeriosis.

In the case of incontinence or prolapse (where the pelvic organs begin to protrude from the vagina), patients who’ve booked surgery to fix the problem are opting out because of articles citing horrific side-effects of the surgery, including holes in the bladder or urethra, infection and severe bleeding.

Fear factor

“We are getting more and more women phoning our practice saying that they are afraid of surgery because of articles they have read on the internet,” says Jana Thiart, office manager for the Urogynaecology and Laparoscopy Clinic (ULC) in Cape Town.

“We even had one woman who phoned at 22:00 to cancel her surgery scheduled for the next morning because of an article her sister-in-law had read.”

Read this: What exactly is… incontinence?

The articles in question are related to lawsuits levelled against manufacturers of the transvaginal tape, a thin, woven plastic made of polypropylene that’s inserted around the pelvic organs to provide support for incontinence or prolapse. The manufacturers, most notably Johnson & Johnson, are under fire for creating mesh that have led to pain and complications in the surgery.

How the mesh works

“Tension–free Vaginal  Tape (TVT) was first used in Sweden in 1997,” said Dr Stephen Jeffery, who heads the Urogynaecology at UCT’s medical school. “It was widely recognised as being one of the most significant innovations of our time and has had a positive outcome for thousands of women.

"But patients need to understand that there are two very different mesh products. The sling [made from the same fabric] is very narrow and is a safe and effective treatment for many cases of incontinence. The product that was recalled by Johnson & Johnson is the Prolift, a much bigger and more invasive device.”

Read this: ‘I had a prolapsed bladder – here’s what it’s like to be incontinent’

Dr Paul Kruger, urogynaecology expert at ULC, says it’s a combination of factors creating a sense of fear for patients. Not only is the manufacturer a factor, but also the way the surgery is performed.

“When we talk about prolapse mesh, it’s a much larger piece of mesh that’s inserted. If it’s done through the vagina, you have a lot of complications,” he says. A safer option is insertion of the mesh via the abdomen.

Questions to ask if you’re doing incontinence surgery

If you’re undergoing surgery for prolapse or incontinence, it’s important to know how the surgery will be conducted. If you’re going for incontinence surgery, you’ll need to know about the different placements of the sling.

Retro-pubic slings are regarded as a safe method, says Dr Kruger. It involves the sling being inserted through a small cut in the vagina and exits just above the pubic bone. “It’s been on the market for 17 years and it has very low complication rates in terms of pain,” he says. There’s also the transobturator operation, which has a higher rate of pain, says Dr Kruger.

If you’re undergoing surgery for prolapse, find out where the mesh will be inserted. Vaginal insertions are associated with a higher rate of complications, while abdominal insertions are not. Then, make sure your doctor is well-versed in the operation and has performed it successfully before.

Check out for more info, or visit IUGA (International Urogynaecogical Association) for tons of patient info.

This article was originally published on

Image credit: iStock