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Bladder sling surgery repair?

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.
76 Responses
Avatar universal
MEDICAL PROFESSIONAL
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.

875863 tn?1271606985
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.
Avatar universal
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
Avatar universal
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?
Avatar universal
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?
Avatar universal
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....    
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