Though they are widely used, mesh slings can cause complications for some women. As industry-leaders in placing mesh-tape slings, Doctors Miklos and Moore are also renowned for their ability to safely and effectively remove mesh slings, even in the most complex of cases.
TVT Sling is an operation to treat stress urinary incontinence, which is a leak of urine that occurs with activities that cause an increase in abdominal pressure such as coughing, sneezing, jumping, lifting, exercising, and in some cases walking. This leakage occurs because the muscles at the bladder neck have lost their supports and strength. As a valve mechanism, the urethra no longer stays closed when extra pressure is put on the bladder.
Stress urinary incontinence is an underdiagnosed and underreported medical problem. SUI affects 15-60 percent of women, and is a disorder that affects both young and elderly women. For example, more than one fourth of young college athletes experience SUI when participating in sports.
Female SUI may be broadly subcategorized into types I, II, and III:
- Type I SUI is defined as urine loss occurring in the absence of urethral hypermobility. This is the mildest form of SUI.
- Type II of SUI is defined as urine loss occurring due to urethral hypermobility. This is also known as genuine stress urinary incontinence (GSUI).
- Type III SUI is defined as urine leakage occurring from an intrinsic sphincter deficiency (ISD). ISD is a more complex form of female SUI.
The subcategories of female SUI can be ascertained by direct physical examination and by measuring an abdominal leak point pressure (ALPP). ALPP, also known as the Valsalva or stress leak point pressure is defined as the lowest abdominal pressure necessary to cause urine leakage.
TVT, or tension free vaginal tape, combines the use of PROLENE polypropylene mesh tape, with a traditional surgical procedure known as the sling, to correct stress urinary incontinence. The mesh is positioned underneath the urethra, creating a supportive sling. When pressure is exerted, such as during a cough or sneeze, the TVT sling will react if needed.
In TVT surgery, a mesh tape is placed under the urethra like a sling or hammock to keep it in its normal position. The tape is inserted through tiny incision in your abdomen and vaginal wall. No sutures are required to hold the tape in place. TVT surgery takes about 30 minutes and may be done under local anesthesia so you can cough at the surgeon’s request to test the tape’s support of your urethra.
Usually within hours of your surgery, you will be asked to urinate to test how your bladder and urethra respond to the surgery. You may be released to go home the same day as your surgery, or you may remain in the hospital overnight. TVT surgery usually causes minimal pain and discomfort. Although you may resume most normal activities in one to two weeks, you will be advised to refrain from driving for two weeks and from sexual intercourse or strenuous activities for six weeks.
About eight out of ten women are cured, or “dry”, in the year following their TVT surgery. Surgery time, hospital stay, and recovery time are all shorter for women who have TVT compared to women who have retropubic suspension surgery.
All synthetic slings have the potential for complications or symptoms such as mesh erosion (in the urethra, or base of the bladder), mesh extrusion (in the vagina skin), vaginal discharge, recurrent urinary tract infections, vaginal bleeding, painful intercourse, incomplete bladder emptying, urinary retention and pain with urination. However, TVT (or retropubic) have risks specific to the placement of the mesh, including:
- Lower abdominal pain
- Mesh erosion (dome of bladder)
- Mesh erosion (colon or bowel)
- Mesh extruding (skin of lower abdomen)
TVT Slings should be removed for a number of reasons, including all of the symptoms mentioned here. The amount of the TVT removed is dependent on the patient’s specific complication and symptoms.
Because of social stigma, an estimated 50-70 percent of women with urinary incontinence fail to seek medical evaluation and treatment. Of individuals with urinary incontinence, only five percent in the general community and two percent in nursing homes receive appropriate medical evaluation and treatment. Patients with urinary incontinence often endure this condition for 6-9 years before seeking medical therapy.
If you’re suffering, rest assured knowing that Doctors Miklos and Moore are highly educated and are able to help you feel like your former self.