WHAT ARE THE SYMPTOMS / PROBLEMS OF PARTIAL SLING REMOVAL?
Patients who best benefit from only partial sling removal are rarely patients who suffer from severe chronic pelvic pain. Don’t get me wrong they may have pain and it may be long term, but rarely is it severe. Then again as a surgeon who has been performing these surgeries (mesh removal) for 25 years, I always learn something new.
The patients that most commonly receive partial sling removal from me, Dr. Miklos, are patients who are usually present with the following signs and/or symptoms.
- Vaginal mesh exposure or extrusion – creating irritation, burning, vaginal bleeding or discharge, and pain with or without intercourse years; often with sling extrusion the partner can feel the mesh too. In this scenario, just the portion of mesh exposed can be removed (FIGURE 1)
- Urinary Retention or Incomplete bladder emptying – the sling is too tight making it difficult to empty the bladder. In this situation Dr. Miklos finds either cutting or removing 1-3 cm of the vaginal portion of the mesh will remedy this problem. (FIGURE 2)
- Painful intercourse –some patients may only have pain with sex due to mesh extrusion or exposure. The pain is usually remedied by just removing the exposed portion of the mesh and closing the skin. But sometimes the patient has pain with intercourse and is without mesh exposure or extrusion. Often the pain is due to the mesh sling being too tight. In this situation Dr. Miklos finds removing the total vaginal portion of the sling 5-7 cm will remedy this problem. (FIGURE 3)
- Vaginal pain or burning- patients will describe vaginal or urethral burning/pain. In this situation Dr. Miklos finds removing the total vaginal portion of the sling 5-7 cm will remedy this problem (FIGURE 4)
Many patients explain that their previous doctors will say, “It’s not the sling” causing your pain as there is no evidence of mesh exposure or extrusion. In other words if they don’t believe the mesh is the cause of their pain. I assure you the sling does not need to be exposed to cause pain. Nor does the sling need to be exposed to cause painful intercourse. Also of interest: surgeons will often tell the patient they are removing the whole sling, when in fact they mean the whole sling which they visualize, ie. what they see, which might just be 0.5 – 1.0 cm (FIGURE 1) (VIDEO 1)
Figure 1: Mesh Extrusion
Figure 2: Tight Sling at the time of dissection causing urine retention
Figure 3: Removal of Mesh for incomplete bladder emptying
Figure 4: Removing 5-7 cm of the mesh for symptoms of painful urethra or painful intercourse due to the mesh
WHY CHOOSE MIKLOS & MOORE UROGYNECOLOGY FOR PARTIAL SLING REMOVAL?
EXPERIENCE -First and foremost at Miklos & Moore Urogynecology the doctors listen. They have been removing mesh since 1998 and have seen, treated, or removed just about every type of mesh complication known to man. They have removed more than 1000 pieces of mesh with minimal complications and superior success.
EXPERTISE – They have treated patients from all over the world for mesh complications. They have produced award-winning videos which have gotten them international acclaim for their mesh-removing technique. They have minimal complications doing any type of mesh removal surgery.
KNOWLEDGE – They are Rule 26 medical legal experts who understand the law and malpractice cases facing patients today. They are also leaders in the world on mesh complications as they have written some of the largest papers on mesh complications found in the worldwide literature.
RESULTS – Miklos & Moore Urogynecology have addressed and removed mesh after being presented with some of the most difficult situations possible. If they can remove the total mesh in some of the most difficult cases, they can certainly address and remove the less difficult which requires less expertise.
RECOVERY TIME AFTER “PARTIAL SLING REMOVAL” SURGERY?
Recovery time is dependent upon the amount of mesh removed, the location of the removal as well whether concurrent reconstructive surgery was performed. In general, if the patient is just getting mesh removal the patient is free to return to normal activity in 6 weeks. Patients are instructed not to engage in intercourse and maintain pelvic rest during this time.
However, if a patient is getting mesh removal and is going to have reconstructive surgery at the time of mesh removal, most likely their recovery will take 12 weeks. This does not mean the patient will have pain the whole time, what it means is the reconstructive surgery will need time to heal and scar in place.