Bladder sling surgery repair?

[ppmom1124]

I had the Monarc bladder sling surgery a month ago. I am voiding fine, and don't appear to have the stress incontinence anymore; however, I am in constant discomfort since my stitches are still protruding from my vagina. My surgeon says that I have had erosion through the vaginal wall, which is apparently one of the possible complications. I have been told that my options are: excise the piece of the sling that is pushing through my vagina (touted as the least invasive w/fastest recovery time); remove the sling and go back to the original problem of incontinence; excise the protruding piece and replace it with a piece of another sling (?); or  replace the sling. I was leaning toward the excision of the piece of sling (I'm already out of sick days, so time off was a concern), but am now leaning toward a longer-term solution of replacing the sling. My surgeon has deferred to another urogynecologic surgeon w/more experience than she has with repairs. I have made 2 additional appointments w/other urogynecologists for second opinions, but was unable to get in for another 2 weeks. I want to have the repair "yesterday"! All I can do after work is lay on the couch; I want to move on w/my recovery.

After all of this, my question(s) is (are): how common is the bladder sling surgery repair? At what point am I in danger of developing scar tissue from this surgery? Will they be able to remove the entire sling, or is it already embedded in my tissues? Would you recommend waiting (w/discomfort) until I can get in to see the other drs. for 2nd opinions? Or should I just go ahead and schedule the surgery since I'm pretty sure that that's what I want to do anyway?


This discussion is related to surgery Feb. 2003--bladder sling--problems.

[Vanessa Lacuesta]

Hi.

The use of sling procedures dated back a century ago and this has been used extensively for women with urinary incontinence. The use of slings have evolved ( see url below) and so does the improvement and skills that come with successfully completing the procedure. However, sling procedures do bring with them their share of complications . Hematoma and bladder perforations as well as erosions of nearby structures such as the vagina in your case may be expected. It is for this reason, that patients need to be evaluated thoroughly prior to the procedure so that the using he right method is ensured.

At this point, literature compares MONARC sling procedure which is a transobturator suburethral sling procedure with other methods of sling procedure and analysis showed decrease risk of complications for the MONARC procedure (http://pt.wkhealth.com/pt/re/ajog/abstract.00000447-200707000-00002.htm;jsessionid=LDrZ1zTwF2vnhqn7qrZ7JGbGb7NFGGWvrpKNj9dLqclWRtGQrbS5!-1990489359!181195628!8091!-1).

Here is a  suggested reading to help you:

http://www.nature.com/ncpuro/journal/vaop/ncurrent/full/ncpuro1052.html

Based on what you have posted, I suggest that you wait for a second opinion with regards to your case. I understand that you may want to have this done with and I can see that your urologist has given you several options to choose from. However, given that this requires another form of intervention and you do require immediate yet long term recovery from the incontinence waiting for a second opinion will be beneficial.

Having the sling excised at this point may be immediate and less invasive. I would opt for a similar procedure. However, it will be comforting and assuring to know that you are actually doing the right thing. Other urologists' opinions will matter at this point.

[jme3510]

I had a Monarch sling in 2004. It broke in 2006. I had to have it removed. (they thought it was imbedded, but luckily, it was not) I had it removed in 2006.
I had another Sling put in in 2007. I am now experiencing pain in my right lower abdomen. I thought it was my back, but after physical therapy and much doctoring, I'm more in tune to the pain and it's like it's pulling away from the wall it was attatched to. It is extremely painful. It kicks my Sciatica in, and wreaks havoc with my lower back. I just figured this out. I quit my job because I could no longer lift heavy things, or bend due to the pain. I'm just now getting to the base of it. I had so much all over pain, that pin-pointing was beyond me. But some of that pain has subsided, and low and behold- there's that pain I feel again. It's been happening since the surgery, but I was never able to pin-point it. (I have Fibromyalgia) Pain is usually nothing to me. I'll find out what's going on, soon. Therapist has ordered an MRI. Doc hasn't even gotten it yet.

[smithy2004]

hi i had the monarc sling procedure last thursday 28/01/10 and hav just had a bath n scratched my stitch off it did not bleed n i am in no discomfort but am really concerned that this wil cause a problem wit the sling. can anyone put my mind at ease please

[kingrider2]

hi i had a vaginal hysterectomy with a monarch bladder sling, i am 4 weeks postop today.  i have constant pulling and pain on the left side of the groin and abdomen.  i saw my surgeon 2 weeks postop and said that i have to give it to 8weeks.  two days ago i missed a step and hurt myself, went to the ER and was given more pain meds.  how long until you feel normal?  will the pulling and tugging go away? if i have it removed how long is the recovery time? should i wait to see my surgeon in 4 weeks or get a second opinion?

[nanasan888]

I had bladder sling surgery in 2002.  In 2009, I developed a cystocele and it has been very uncomfortable.  Could it be that the sling has created this cystocele?  If so, what are my options.  I was told when I had the sling surgery that it would probably last only about 5 years.  So, what happens to the mesh sling?

[interalia]

Positive comments here -[ I had the vaginal sling (monarc) just a week ago - I can't believe the difference.  The post-op discomfort was almost negligable, and I have already experienced the bliss of sneezing and coughing without having to cross my legs.  After one week, just started to develop an ache during the night from left groin to left knee, but nothing I haven't had at various times before (advil works fine).  Before going into OR, my OR nurse told me she had the same procedure from same surgeon (surgeon by her request) and it was the best thing she had ever done.  I'm feeling the same way, so far....    

[mewden]

I am interested in what procedure your dr. used. It is nice to hear somne positve comments. I may have to have this surgery and am glad to hear that there aare some good sides to it!
thanks for sharing your experience.

[alanasmom56]

I'm curios- have you had the procedure done yet? I'm at the point you were at when you wrote your post. Wow, all the comments are scaring me, seems like there's so many post-op problems. Do you suppose that the sucessful ones just don't go online and tell about it, or is this just a really unperfected surgery that doesn't turn out well in most cases? After reading all these horror stories, I feel almost like just living with it & all its symptoms. It's better than things poking, pulling imbedding, tearing, falling out, and all the other terrible things that the ladies are describing!! What do you think?
Mortified in Riverbank.

[nicki700]

I just saw your post. I've been online the past two days trying to find out possible complications due to the mesh sling surgeries, being that I actually had all 3 kinds of prolapse 2 years ago in April and my bladder is now giving me problems once again. I noticed the problem after intercourse and thought I was developing a bladder infection. I'm now concerned that maybe the sling has shifted and is no longer working correctly. I would suggest researching some other options online before having the surgery. I wish I had because now I may be looking at another surgery to fix the problem and it was not a fun recovery for me to begin with. I think this is such a huge problem for women and needs to be talked about more, and I truly believe that if it was talked about more they could come up with a much better solution than putting a foreign object in us to hold our bladder up. I'm only 31 years old so I had the surgery when I was 29 and it was devastating to me. I have two kids and wanted another one and felt it was taken away from me since I had to have a hysterectomy. I feel like a young person living in an old persons body and sometimes I wish someone had told me this could all happen before I decided to have children. It may have changed my mind about everything in my life.

-nicki, salt lake city, utah-

[galias73]

I had the sling surgery one week ago,I regret it doing it. I'm 37 years old,I leaked everytime I sneezed or cough,but not a lot. When I went to the doctor he told me I needed it. After I read all this information about complications,it's only recommended it for people with severe leaking and I wasn't that person. Now I'm suffering with pain,constipation,going to void every 15 minutes. I'm thinking to have it reversed.

[zacsmimi]

Dont give up. Without it it would have gotten worse.

[jakost]

I am scheduled to have the bladder sling surgery on Monday morning (3/72011) and I am just curious how many women had to go home with a catherder after the surgery?  My ob gyn tells me it is a 10% chance that I will have to self-cath or have a cath in all the time for a few days after the surgery.  Has anyone had to do this?

[flower2011]

I am 43, i had a hysterectomy and bladder sling done in 01-2011. I went 4 1/2 weeks, with a catheter and had to self catheter. 5th week my bladder would not void  at all.  I had to have a second surgery to  loosen the sling, my surgeon  ended up taking out the sling. Came home with a catheter and had to catheter for another week. I have extreme pain in left side of vagina and down leg. Went back to work after 8 1/2 weeks off.  And am in constant pain standing.  Now mt dr. tells me i will need another surgery, because my bladder  will be doing the same before this surgery. And tells me the pain is because i am still healing ......... I want my old life back. I was very active and now i can barely walk without pain !   I say DO  NOT GET THIS SURGERY !!.... The leaking when sneezing, and laughing was much more tolerable, than this pain !!

[eleisha]

I am 50 and had bladder sling surgery one week ago.  The catheter was
taken out 12 hours after surgery and I had no problems holding on or going to the toilet.  I was scanned each time I emptied my bladder and it was emptying well.  I was up and about the next morning and experienced no
pain at all and would not have even known I had an operation.  I felt normal. The only thing that upset me was the anesthetic as it caused me to vomit afterwards but I was fine by the morning.  I had a mild prolapse before the operation and would leak slightly with coughing and sneezing and intercourse which I wasn't happy with. I decided to have it done before menopause hit me. My mother had the operation too around my age and she was fine up to the day she died 30 years later. I guess it is early days yet and I will see how my checkup goes in six weeks time but so far I am completely happy with my decision.

[eleisha]

I was reading your comment today and I agree with you that the successful operations probably aren't posted.  Perhaps the women who are happy with their op get on with life and don't go on the internet looking for problems with this same type of operation.  So far my op went really well though it has been only nearly two weeks since I had it done.  It may have a lot to do with the doctor who does the op.  My doctor specialized in bladder repair and had been doing it for 30 years.  He told me I wont even know I have had it done and so far I agree.  I remember my Mum having this operation and her doctor told her that he is always being called out to aged care homes to help women with their bladders fallen right out and ulcerated and had lived with this problem for years because they were too scared to see a doctor about it to see what could be done.  I dont want to be in that situation.

[jclaireg4]

I had the surgery 2 weeks ago and I am hoping it will get better. I have been having cramping the the pulling sensation mentioned above.

[Dimsie]

I know 3 women who have had this procedure done and they've had no problems once the healing was complete. I imagine this is the usual case and such women don't need a forum like this one as they've no questions to ask. So don't be too worried if you're due to have this surgery, the chances are you'll be fine! Remember that it's people who need answers who come here and obviously mostly their experiences haven't been as good as others. This forum is very good, many people get answers, but we shouldn't assume that the experiences of people here are typical of the wider community.

Best of luck to all. I should add that I had a hysterectomy almost 30 years ago and once healed up I was fine. I'd had bladder issues and they were gone, I've had no problems since. So you see, not everyone has problems. I should add I only came across this discussion as I was looking up information on minor leaking for my very elderly mother.

[Bek2101]

Im 30 years old and booked in for Monarc sling procedure in one week. Im a runner who trains every day. I have to stop any fluid intake 3 hours before a run and even then i leak badly. During a race (10km) i wear a pad and Contiform to help stop the leaking by the end the pad in full and my shorts are wet. Im scared to go through with the procedure because if i wasnt a runner i could live with it as its only when i run or jump that i leak. My two children are my life but running is also very important to me. Is there any runners out there that have had the procedure done? Id hate to have it done and im not better off.

[tap663]

  58 yrs old  I had monarch sling 5-2-11 It has been 2 weeks and I am still spotting bright red blood, when will this stop?  

[dkohl]

I had the bladder sling put in just over a year ago, I had leakage and then it got to where I could not hold it at all . They said the sling would help. Well I was doing good for a couple months then I started feeling these pains in my right side I have had alot of pain with it also I feel like something is just being pulled apart in side my body on my right lower abdomen.then I started leaking just a little again until a week ago I was at work and I had the urge to go so I started to walk to the bathroom when it just came out. I am only 32 years old I AM TO YOUNG FOR THESE PROBLEMS. I have been told that it can do a lot more damage to u if they try to take the sling out and that sometimes it is already grown in to your tissues and it might just be impossible to get out. I could end up having a bag put in.....I don't know what to do. I wear pads but they can not hold what I am releasing . I do not wanna go to work or shopping or anything because I am afraid of wetting my pants. . I feel like I am at the end of my rope . I guess It is time to start buying diapers. I do not wanna have another surgery done . I have had a hysterectomy when I was 22 and they tact my bladder then and then the sling surgery last April . Is there not anything they can do I mean really? -- DMKOHL

[Lorna1952]

I had the monarch sling procedure done two days ago and so far I cannot empty my bladder will this get better or will I have to self catheterize forever?

[luckysmom201]

I am 44 and I just had this surgery and a partial hystorectomy on Monday.  Everything has gone very well for me so far.  You have to walk in spurts and don't over do it.  My doctor said 4 weeks for a good recovery time and sometimes 6 weeks.  Basically no activity other than walking a little each day to regain strength and get your bowels moving.  That for me was the worst part...my first BM was not pleasant, but am hoping the rest will be better.  For those saying they have issues when releasing the water, if it is after your surgery you have to remember there is swelling in there and that will play a part in that.  I too had that but I am seeing improvement.  I no longer have to lean back to empty my bladder.  Just don't strain or do anything to add stress to that part of your stomach and you should have an easy recovery.

[hjnellie]

My advise to all women out there is "DON'T DO IT"....

[cathrinedh]

Monarch sling done in spring 2008 when I was 51.  As I was going through menopause the leaking had gotten more a regular thing....guess loss of estrogen/tissue tone.  I took 6 weeks off all excercise, including carrying in groceries (threatening my teen sons with description of the procedure details got me lots of help).  I'm happy with my decision, it's been over 3 years and the only complication I had was a crampy aductor muscle periodically for a couple weeks from the lovely position they put your legs in during the procedure.  I would recommend this procedure, as well as some hip stretching excercises ahead of time...  There are risks with all procedures though!