Obstruction from SPARC urethral sling

[Kathi Kimmerle]

Hi,
I am a 40-year-old female in general good health. I had a SPARC suspension 2 1/2 years ago, which has caused me lots of trouble; i.e. urgency, frequency, pain, periodic retention, etc. I have also had numerous abdominal and vaginal operations for gynecological problems; i.e. hysterectomy, appendix, VV suspension, ovary removal and c-section. I have had problems with adhesions in the past.

The urologist that did my surgery kept treating me with meds, which never helped. I finally went to another urologist who performed several tests - Urodynamics Study, Biofeedback & Cystoscopy. The Urodynamics study revealed an obstruction, and the doctor told me he would rate my test result at a solid "9" out of "10", meaning it was one of the most abnormal Urodynamics Studies that he'd ever seen. I completely flunked Biofeedback, and the cystoscopy was a nightmare, causing horrible urethral pain. Although, interestingly enough, the Cystoscopy didn't reveal anything terribly abnormal other than intense pain during catheter insertion - and severe spasms and pain for almost a week following the test.

The second urologist has referred me to another doctor who is a "super specialist" in pelvic pain disorders. I believe he is also a urologist. This new doctor wants to do a sling take-down operation. What are the success rates for sling take-downs that have been left in for as long as mine has been? Will the sling take-down itself cure the severe bladder spasms and pain? Could there be adhesions involved? Any advice would be greatly appreciated! Also, I'd like to hear from other women who have been through something like this. I'm quite frustrated, and at the end of my rope here! :-(

Thanks so much!

[Kevin Pho, MD]

I am not a urologist, so my input will be limited.  When a take-down procedure is considered, it is generally regarded as the last resort.  I am not able to quote statistics as to the success rate - not can I comment on whether the sling take-down is guaranteed to help the bladder spasms and pain.  

With the amount of surgery done, adhesions can certainly be a possibility worsening the symptoms.

If there are questions regarding this course of action, it is always reasonable to obtain a second urological opinion - preferably at a major academic medical center.  

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
Medical Weblog:
kevinmd_b

[Dustymom]

A related discussion, urethral sling was started.