TVT Sling Removal
Identifying Signs and Symptoms of an
Unsuccessful TVT Mesh Sling Procedure
An unsuccessful TVT sling procedure may not only result in unresolved leakage but can also lead to additional issues impacting the patient’s overall well-being.
Some common complications associated with a failed TVT sling include:
1. Chronic Pain: Chronic pain is a prevalent and severe complication arising from transvaginal mesh surgery. Nerve damage, mesh erosion into neighboring organs, and excessive scar tissue can contribute to pain, affecting the patient’s daily life.
2. Painful Intercourse: The mesh used in the procedure may cause discomfort during sexual activity for both the patient and her partner. Pain can arise from scar tissue tension on nerves or complications such as exposure, extrusion, or erosion of the mesh.
3. Infection: Infections result from bacterial overgrowth, leading to an inflammatory reaction in the bladder and/or vaginal wall. Symptoms may include pain, fever, or unusual discharge.
4. Mesh Exposure: Mesh exposure refers to the visibility of the mesh through a defect in the vaginal skin. This can cause issues like bleeding, infection, pain, or painful intercourse.
5. Mesh Extrusion: In cases of mesh extrusion, the mesh protrudes above or beyond the skin’s borders, causing complications such as bleeding, infection, and pain during intercourse.
6. Mesh Erosion: Mesh erosion involves the mesh penetrating neighboring organs like the urethra, bladder, or rectum. Symptoms include pain, bleeding, infection, and discomfort during urination or defecation.
7. Urinary Problems: Various urinary issues may arise, including retention, incomplete bladder emptying, urgency, frequency, nocturnal urination, overactive bladder, recurrent urinary tract infections (UTIs), and urinary incontinence.
If you experience any of these signs or symptoms post-TV mesh surgery, it is crucial to consult with an experienced mesh removal surgeon or healthcare provider for a thorough evaluation and appropriate treatment. Incorrect evaluation or treatment of mesh failures can lead to further complications, exacerbating conditions and making future mesh removal surgeries more challenging. Most centers will not remove the entire TVT sling, Dr. Miklos specializes in complete TVT sling removal.
Recovery Period Following Unsuccessful TVT Sling Removal Surgery
The recovery timeline after failed TVT sling removal surgery varies based on the specific procedure undertaken. Here, we categorize recovery into three types of TVT sling removal, each depicted in the medical illustrations provided.
Transvaginal Mesh Sling Incision or Partial Removal:
Procedure: Involves a single incision under the urethra, typically around 2 cm in size.
Postoperative Experience: Patients often experience minimal postoperative pain.
Recovery Time: Generally an outpatient procedure, allowing patients to return to work the next day.
Restrictions: No intercourse for 4 weeks; most patients are pain-free within 1-2 days.
Partial Removal of 4-6 cm TVT Sling:
Procedure: Removal of a portion of the TVT sling.
Recovery Time: Little postoperative pain; outpatient procedure.
Return to Normal Activities: Patients can usually return to work the next day.
Restrictions: No intercourse for 4 weeks; most patients experience pain relief in 1-2 days.
Total TVT Removal:
Procedure: Involves transvaginal sling removal followed by laparoscopic TVT arm removal through the abdomen.
Hospital Stay: Typically one night in the hospital.
Full Activity Resumption: Patients can generally return to full normal activity in 6 weeks.
Additional Operations: If a concurrent anti-leakage operation is performed, restrictions on heavy lifting or intercourse may extend to 6-12 weeks.
Pain Relief: Most patients experience pain relief within 1-2 weeks.
Total TVT Removal from Urethra, Bladder, or Bowel:
Hospital Stay: One night.
Postoperative Recommendations: Pelvic rest for 6 weeks, avoiding sex, heavy lifting, or straining until abdominal incisions heal.
Extended Recovery: If a non-mesh anti-leakage operation is performed concurrently, recovery may extend to approximately 12 weeks.
Pain Relief: Most patients are pain-free within two weeks of surgery.
These general guidelines serve as an overview of the recovery process after different TVT sling removal procedures. Individual experiences may vary, and it is essential for patients to follow personalized postoperative instructions provided by their healthcare providers.