Women who have suffered serious complications from vaginal mesh may not have been properly counselled about side effects, England's chief medical officer has said.
Professor Dame Sally Davies said that she had received "tragic" post from affected women.
But she said that for a select group of women, mesh is the "best treatment".
Meanwhile she admitted that she herself had suffered incontinence after giving birth.
During a Facebook Live chat with Health and Social Care Secretary Jeremy Hunt, Dame Sally said: "There has been undoubtedly been bad use of vaginal mesh.
"We women after we have had babies can be damaged, so that we have incontinence.
"Actually, and I have never gone public about this - after my first child, I could walk three yards before I peed in my pants.
"For six weeks I could not the leave the house. And I'm still not as I would wish to be so I have every sympathy with these women.
"It's quite clear that for a selected group of women, the best treatment - if you have got a good doctor - is to have a type of mesh that lifts the bladder up and supports the uterus and makes it all right.
"But even if you have got a good surgeon and the right patient, there are quite a lot of side effects - 15-20% get side effects."
She said she had received "tragic" letters and emails from women who suffered complications after being fitted with mesh.
"It's bad enough suffering from incontinence - I know - but who are worse off because of pain," she said.
"My heart goes out to them."
She added: "But it is quite clear from the letters that they were not properly counselled about the side effects and that many of these women who have written to me probably did not have the right surgeon and may not have been in the group who should have had it.
"And so we have got to be very careful about the evidence so we don't stop women who are in the right group with an expert surgeon going for it if they have been counselled about side effects, but on the other hand we protect women from surgeons who may not be fully informed or don't counsel properly.
"So this is a really difficult area.
"I really was moved by the emails I have had this weekend by women who are in real pain and suffering."
Last week Mr Hunt launched a review into how the NHS responds to safety concerns raised by patients about medicines or medical devices.
In particular it will look into patient concerns about vaginal mesh along with hormone pregnancy test Primodos and epilepsy drug sodium valproate.
It will also consider whether a full investigation or a public inquiry is necessary into any of the issues.