According to the Senates report, the implants are medical devices surgically inserted to prevent prolapse and urinary incontinence—conditions that affect many women over their lifetime, with around 20% requiring surgical treatment

The inquiry was the result of many women coming forward reporting severe side effects, such as chronic pain and trouble walking, after vaginal mesh surgery. 

Recommendations included that these medical devices are to be used only "as a last resort," that each mesh implant is registered, patient counseling and decision-making, surgeon training and better reporting of adverse events.

Proposals to improve outcomes for patients by implementing stricter standards in training, audit, research, and monitoring of medical implants are welcome. However, the Senate has lumped together incontinence and prolapse devices, considering them all to be "transvaginal meshes."

Only the prolapse devices are problematic, while those used for incontinence are safe and evidence-based procedures. Conflating the two confuses women and may lead them to seek snake-oil type treatments that have no evidence base, and can be risky.

Prolapse and stress urinary incontinence conditions are types of pelvic floor dysfunction, but the surgery and medical devices used to treat them are different.

Despite many submissions to the inquiry from clinical bodies, the Senate committee has been unable to distinguish between midurethral mesh slings and transvaginal mesh. The first is a mesh tape placed under the urethra like a sling for support. 

The second is sheets of mesh positioned under the bladder, or in front of the bowel, to stop prolapse and prevent recurrence.

Midurethral slings in Australia have been associated with complaints in around equal numbers to mesh used for prolapse, but proportionately most problems have been seen with prolapse. This is because an estimated 120,000 sling operations have been performed, compared to only around 30,000 prolapse mesh procedures.

There is still clinical uncertainty and insufficient data on indications for use and best practice when it comes to the mesh used to treat vaginal prolapse.

A review of several studies found that the artificially grafted mesh had more problems than benefits, and the women who underwent the operation had high rates of needing repeat surgery due to mesh exposure, bladder injury and urinary incontinence.

Midurethral slings, however, have an excellent track record and are the most researched incontinence procedure in history. 

There is no requirement from the commission that such procedures have proven efficacy and safety. This means that, in theory, an utterly nonevidence-based treatment such as vaginal laser could be claimed as a continence procedure. 

The vaginal laser is mostly a cosmetic laser treatment, for which there is entirely no scientific data for any effect in patients with urinary incontinence.

Along with the Senate's recommendation that mesh is used as a "last resort," this suggests patients should be offered less effective procedures, such as injection therapy, or significant abdominal operations, with more complications and no better efficacy, merely because they don't involve mesh.

Researchers have already seen a reduction in continence surgery over the last several years, which could be related to adverse mesh publicity. This has not been replaced by an increase in conservative management. Rather Australian women are now continuing to suffer with their incontinence. And there is a risk they will turn to expensive "snake oil" treatments, such as vaginal rejuvenation therapy.