Sling Procedure

[Havaheart]

I am scheduled for surgery on Jan 14, 2007.  My gyn will be doing a D & C, an Endometrial Ablation, or Hysterectomy, and a TVT-0/ Sling Procedure. I had a positive endometrial biopsy and have went through testing on my bladder called Urodynamics.  My bladder wall is collapsing against my vaginal wall.  I'm only 41 years old.
I'm scared because I have read a lot of negative things about the Sling Procedure.  They plan on doing it vaginally and I was told I would be coming home with a Cath.  I'm really worried about sexual dysfunction following the procedure.  If there are any positive outcomes from this procedure I'd love to hear from you.  I see my Gyn in the morning Jan 2 and do plan to ask her all this but thought I'd see what y'all have to say.
Thank you

[chevy628]

I had a bladder sling and an ablation surgery 2 years ago.  I began leaking fluid a few weeks after the surgery.  I have been to a gyn and a bladder doctor.  They cannot locate where I am leaking from.  There is no fluid in the uterus.  The bladder is not leaking.  I have been leaking for 2 years.  My gyn recommends a hysterectomy.  I am thinking what if a hysterectomy doesn't correct the problem.  I am tired of going through this.  Please help!!

[grahnbeading]

I am scheduled for a hysterectomy and TOT.  My understanding is the sling procedures (TVT or TOT) are highly effective in curing USI. Once you have a sucessful sling, how long should it last? Thanksl

[Lennox Hoyte, M.D.]

The sling is usually done if you have problems with urinary incontinence (leakage), related to coughing, laughing or sneezing - also called stress urinary incontinence. If you are not having these symptoms, you should think twice about having a sling procedure. That said, for women who have the sling for stress incontinence tend to get cured of the stress incontinence. THe sling incisions heal well, with minimal impact on sexual function.  However, sometimes they can develop urinary urgency, and sometimes urge incontinence (urine leakage associated with a strong urge to void). The urge problems tend to resolve by about 12 weeks after surgery. Also, it sounds like you have had a problem with uterine bleeding, and your endometrial biopsy may have showed endometrial hyperplasia, which is a precancerous condition. If so, the treatment for that is hysterectomy, or high dose progesterone, not ablation. The other problem you seem to be describing is prolapse, which is a falling down of the vaginal walls and/or uterus. This is only a problem if the uterus or vagina is falling past the labia, and this is interfering with your lifestyle. If you have true prolapse, then you need to have more than just a hysterectomy, you will also need to have the vaginal vault suspended to keep it from falling down again. From what you have said, you have 3 diagnoses; stress incontinence, endometrial hyperplasia, and prolapse. This is an unusual mix of diagnoses, and it would make sense for you to get a good explanation of how the diagnoses were arrived at, and how the proposed surgery will fix each one.

Dr. Hoyte