Peeing when you don’t mean to is not a great situation. You’re trying to exercise or laugh at a funny television show, and suddenly you leak a little bit. There are different types of urinary incontinence, but today we are going to discuss “stress urinary incontinence,” a common health issue mainly affecting women.
Stress urinary incontinence, also known as SUI or effort incontinence, occurs when the bladder’s muscles weaken and the urethra cannot completely close. This results in urine leakage whenever there is intra-abdominal pressure. This pressure can be created by small things such as sneezing, laughing, coughing or exercising.
The condition is fairly common after childbirth, though hormonal changes, aging, smoking or being overweight can also contribute. Men rarely develop SUI, though it can happen after prostate surgery.
SUI does not cause pain; women describe it as embarrassing, isolating and inconvenient. One can imagine how mortifying it might be to pee around friends during social situations. Symptoms include the unintentional leakage of urine when:
Some women experience incontinence every time they do those activities, and some feel it just part of the time or only when their bladder is full. When this begins interfering in daily activities or causing emotional issues (depression is very common among SUI patients, and three out of four women do not seek treatment for it), patients should consult with a medical professional.
There are no medications for stress urinary incontinence. Cymbalta, an antidepressant, has been prescribed for SUI in Europe, but the United States has not followed suit. The most prominent side effect is nausea, and SUI symptoms will quickly recur when the medication ceases.
Doctors will likely begin with the following.
If none of those works, your physician will move to the next step of treatments.
Transvaginal mesh has long been considered a treatment for SUI because medical device companies claimed said it would extend the life of any repair. While the product originally began as a treatment for abdominal hernias, in the 1970s surgeons began using it for pelvic organ prolapse.
Then, in the 1990s, they started using it for stress urinary incontinence. Until 1996, surgeons would cut the piece of mesh for each specific patient. That year, however, the first surgical mesh kits for stress urinary incontinence was approved by the Food and Drug Administration. By inserting mesh screens into their patients, doctors could support weak and sagging muscles. Tissue was encouraged to grow around the implant, anchoring it in place.
The FDA records of adverse events via the MAUDE database (Manufacturer and User Device Experience), through which both doctors and patients can report medical outcomes. After reviewing more than 1,876 complaints in a three-year period, they noted that a significant number of women with SUI who are treated with surgical mesh experienced erosion (also called “exposure,” “extrusion” or “protrusion,” meaning the mesh was sticking out of the vaginal opening, migrating or perforating organs). Women also experienced:
After researching the complaints of those 1,876 women, the FDA concluded that:
There have been so many complaints and reports of adverse effects that in 2017, the FDA reclassified surgical mesh for stress urinary incontinence surgeries as a Class II medical device, which is the category associated with medium risk.
You should weigh the benefits of surgical mesh with your surgeon. The FDA provides a useful list of questions, including “Will my partner feel the mesh during intercourse?” and “If I develop complications, can you remove the mesh?” (Not all surgeons who insert mesh can remove it.) Ask for any other treatments before attempting a mesh surgery.
Many women are fine after being inserted with surgical mesh. It adheres to the right area, encourages tissue growth and doesn’t cause pain. They get on with their lives and forget they even have an implant.
Other times, there are terrible complications. It can take years for issues to develop, though the average seems to be three to four years. Some women live in extreme pain and have trouble ambulating. Others injure their partners during intercourse by actually cutting them with eroding mesh.
As problems with mesh are “not rare,” many women wish they had received more information prior to surgery, especially because very often the implant cannot be entirely removed. Mesh implants encourage tissue growth, so removal can require more than one surgery or be physically impossible. Some can’t sit for more than an hour or have vaginal bleeding. They have also reported other physical issues like chronic low-back pain or thigh pain, difficulty walking, recurrent incontinence and more.
Additionally, synthetic mesh is made of plastic called “propylene,” which can harden when exposed to heat. Bodies have body heat. That transforms the implant from its original cushy state to what feels like your screen window. This is a point of contention between stress urinary incontinence patients and device companies, because the companies claim that the implant is inert, while patients report that it is not (thus becoming biologically incompatible with the body).
This is why so many women are joining together to sue medical device companies. Read more about lawsuits and complications.
It’s important to think about the following before starting or joining a lawsuit:
This isn’t even a question — yes, and fast. Products liability lawsuits (also known as defective products) require mountains of evidence, including depositions, interviews and more. The device company, meanwhile, has millions of dollars it can use to defend itself. An experienced lawyer knows how to play the game.
Your lawyer can file a motion to transfer your case into an existing multidistrict litigation case (a federal court tool reserved for many similar plaintiffs with common questions of fact). This would save money on pretrial aspects of the case. The other option is for the Judicial Panel on Multidistrict Litigation (seven federal judges appointed to an oversight committee) to order you to transfer into an MDL.
Put bluntly, you will discuss your vagina with anyone who asks, and in excruciating detail. It will likely take a few years to finish the lawsuit, and before then you will be deposed (put under oath and asked questions by opposing counsel about your health complications). If the case proceeds to trial, you might have to testify in open court. Joining a lawsuit means being patient and understanding that you might have to discuss your private problems with strangers. At the very least you will undergo independent medical examinations, which are doctors’ appointments with a medical professional chosen by the defendant.
Nope. Personal injury lawyers work on contingency, taking around a third of the proceeds, plus costs (filing, copying, etc.). That can increase if you go to trial (a normal number is 40% in that instance). Be sure to confirm fees with any lawyers you talk to about your mesh for stress urinary incontinence case.
All legal fee agreements generally have a line that says “Past performance does not indicate future rewards.” All an attorney can do is provide a range of similar outcomes for the same type of case. Some cases go to trial and a jury awards damages; others settle prior to a verdict. Those settlements have reached $20 million for a single plaintiff, like the bellwether case against Ethicon (a division of Johnson & Johnson). However, other women have had their cases tossed out. All of this means that nobody can predict anything. You have to weigh that possibility when considering whether to pursue a transvaginal mesh lawsuit for your stress urinary incontinence complications.
You have to take care of yourself. Your surgeon should understand that, and if he’s experienced, he will have likely been called as a witness before. It will feel awkward, but it isn’t the surgeon’s fault; it’s the implant’s fault. Unless your doctor or surgeon acted negligently – your lawyer can help guide you on whether medical malpractice may be an additional factor in treatment of your stress urinary incontinence.
Before anything else, if you are experiencing pain at your implant site, talk to your surgeon. Get that sorted out first.
After that is the time to get a lawyer. Many women feel more comfortable with a female attorney, as these cases involve intimate areas. You can also start with a Google search:
“Florida defective products OR products liability attorney SUI mesh.”
This will help to filter results, since Googling “mesh implant attorney” will result in thousands of web pages. You can modify the search using your own state and the product used in your treatment for stress urinary incontinence, if you know it.
Once you read online reviews and pick a handful of prospects, arrange to speak with them in person. This will let you know whether you’re comfortable with this person and if they have the resources to help you.
Also, remember that each state has a statute of limitations (the time window in which you can file your case). Once that time is up, so is the ability to file your case. A few states only offer one year for personal injury cases, so if you have to, get any attorney to file your paperwork and then choose a new lawyer for the more complicated aspects of the case.
Products liability law is challenging. You need an experienced lawyer who can work with pending multidistrict litigation cases. If you have not met with an attorney yet, try the Enjuris directory for someone near you who can help.