LAVH: Worried over bladder sling????

I am in the process of co-coordinating the Dr.'s on my surgery... I see the Urologist this Thursday and I have been reading a lot of the posts here in regards to "bladder slings" and I am getting quite scared to be honest. I have stress incontinence and it is a royal pain in the fanny, but I am not sure it is worth starting all the problems I am reading about... I was convinced that the sling would be great, but all I am reading is people who are having issues with urgency, removal, pain, and worse incontinence..... The actual procedure is harder to recover from that the hysterectomy according to my Gyn. so I am debating adding it to my schedule. It makes sense to have it done while I am under and on the table and I do need it.

Has anyone had a good outcome and are you happy you did it?????? What should I expect????? By the way my surgery looks to be a LAVH. The final decision will be made on Thursday.. Any help and advice/opinion would be greatly appreciated..

Hi There:
Sometimes I stop by to see if I can help someone going through the same things I did. I had a tvh, anterior repairs and bladder sling on June 1st and I feel absolutely wonderful. Let me tell you about my experience - I had absolutely no pain at all from the bladder sling. It was the tot procedure and all I had were two very, very tiny punctures on the insides of my legs across from my clitoris. My doctor used surgical glue and there were no sutures. I had no discomfort and would not have even known he did the surgery had I not looked with a mirror. I kept asking my husband if they really did the surgery and he assured me that it was done. I had stress incontinence due to a second degree prolapsed uterus and a third degree prolapsed bladder. My doctor told me that it would take a good six months for the mesh to completely heal and for the scar tissue to totally form. I researched the hell out of this and almost convinced myself that it was not going to work. However, you mostly only hear about the ones that had complications, as most of the rest of us have moved on. I finally discovered that complications are in about 2% of the cases, so that convinced me to go ahead with it. I have not had one day of regret over this. I just had my final follow-up visit with my urologist on October 2 and he told me that everything looks excellent. I have a nice tightened pelvic wall and absolutely no stress incontinence. I will tell you, however, that for the first week after my surgery I still felt like I was leaking a bit when walking, but it went away. I did exactly what my doctors told me to do - I did not bend, lift or carry anything for six weeks and did not get constipated. You will need to make sure you eat a lot of fiber and drink tons of water. I used miralax and my doctor has told me to keep using it as long as needed. I know there are some who say that long term use of it is not good, but I would rather take my chances and have normal, soft bowel movements and not have to worry about straining. I know, too much information! I started walking 2 days after my surgery and went back to work on June 9th. I worked part-time as I was going crazy at home with nothing to do. I did nothing stupid. I rested, walked and tried to get back to a normal routine. Also, I did not take one prescription pain pill either in the hospital or when I got home. All I had from the surgery was some mild cramping ( I have had much worse menstrual cramps through the years) and I took extra strength tylenol when needed. I used the PCA pain pump in the hospital exactly twice and went home 24 hours after my surgery. by the way, I am 55 years old so I am not a young chick by any means! Please do your research, but don't spend so much time agonizing over this. You will make yourself CRAZY! I am here to tell you that there are success stories out there. Also, my sex life with my husband is wonderful. The best we have had in years and I feel great! Good luck to you.

Susan

Hi,
I had a TVH, and a TVT. I had HORRIBLE incontinence before my surgery. I did tons of research and still hesitated on having it done even as I was in pre-op ready to be wheeled into surgery, and asked to sign the final papers agreeing to the surgery. I have had almost a 100% improvement. I leaked a little the day before my 6 week check up. I learned I just need to double void and then I am fine. I had mixed incontinence before the surgery and the urge part has actually improved, but I do still take Enablex. There have been a few bumps in the road along the recovery path, but nothing major. I will never forget 3 weeks after surgery when my husband (who is a funny man) made me laugh so hard. I went to cross my legs and realized I DID NOT LEAK !!! I DID A DANCE I WAS SO HAPPY!!! All in all this surgery has given me my life back. I knew the risks , but my quality of life was so bad to me it was worth a try. Good luck in whatever you decide! Karen

I appreciate your honesty... It is a scary thought that I might make things worse... I worry much more about the bladder sling than the hysterectomy... I feel better.... We will see what Doc says in the AM....

Hello,
Geezersgal, I hope you don't mind me jumping in here... I saw my Dr today, and am waiting for her to consult w my oncologist to make a decision on whether or not I'll be getting Oophrectomy, or hysterectomy. I too am contemplating getting the sling surgery. After looking @ all the info on the internet, I am a little discouraged...But after reading Susan's post, I feel more comfortable...It's true, when something goes well most people move on, and we don't hear those stories as much as we'd like. Isn't it comforting to bounce things off our more experienced sisters?
So, as a result of your post, many questions have been answered, except one....Is this sling inside the vaginal canal? If so, can you feel it? can your partner feel it?
Shawna

One other possibility if you have concerns is using your own tissue for the sling... less of a chance of overtightening and not an issue of rejection/erosion... the down side is whether the strength of the tissue there to begin with...

good luck,
Kathy

Hi:
This is for sss210 who asked about whether you can feel the sling and where it is placed. I had a very experienced urologist do this surgery. He has done it many, many times before. I looked at my surgery report and this is what it said. The tape is placed under the urethra which acts as a "backboard", but not as pressure. Two small incisions were made over the obturator fascia on the right side and the left side at the level of the clitoris. The doctor used a coloplast Aris inserter to pierce the anterior rectus fascia and angled this parallel to the ischium where it was advanced approximately 2 cm. Using a finger to guide it through the vaginal crease, the Aris tape was placed through the eye of the inserter (needle/hook) and it was brought through the patient's abdomen on the patient's right side. A similar maneuver was performed on the left side making sure the tape was not twisted when it was elevated. The tape was lifted up so it just touched the urethra over a Yankauer suction. The area was irrigated with the same antibiotic solution that the tape soaked in. The surgery was finished. No complications were noted and the estimated blood loss was minimal. This tape sits there as a sling and is not tight. If it is made too tight then you cannot urinate. There are some who have had those problems because the surgeon makes the sling too tight. My doctor says he goes by instinct and knows exactly how tight to make this. I cannot feel a thing and neither can my husband. It is like it is not there. I hope I did not bore you with the details, but it is not a complicated surgery, if the surgeon knows his stuff. They actually do this at a local surgery center as an outpatient procedure and the women go back to work a day or two later, of course, with lifting, bending, etc. restrictions. Hope this helps. By the way, my doctor told me he has only had two problems with all of these he has done - one with inability to urinate (but she had many other problems, too and still decided to give the surgery a try knowing it probably would not be successful) and one mesh erosion. Good Luck!

Susan

Geezersgal,
I am 4 weeks post op tomorrow from total abdominal hyster/bladder sling/vaginal repair and I feel good. I have no problem voiding although I did have some bladder spasms the first week and did have a problem voiding after they took the catheter out. It feels so wonderful to cough, sneeze and laugh without having to change my underwear/pants! I was nervous about it after reading posts about women experiencing complications etc but the percentage that do experience them is small in comparison to how many of these procedures are done.

Hugs,
Esther

Ladies -

I am back and feel so much better... Both Dr's put my mind at ease. My Urologist has done approx. 250 per year for years so that is thousands. That takes care of experience. I mentioned all the problems I read about and he said he has read the same thing on line. He has had a couple of occasions with problems, but changed the type of sling he uses and is quite pleased and thrilled with it. I believe he said TVOT....He said he expects me to be an excellent candidate, I have the UroDynamic test on Monday and a Cystoscopy on 12-3-09, they are scheduling surgery now so it is on the books before the holidays.

The Gyn. examined me and was surprised how large my uterus is.....He is really big on keeping the uterus intact for pathology. I agree 100%... He is not sure he can do a LAVH... We may be changing to a TAH...It is a much shorter procedure, the uterus is left in tact. I have agreed with him that I am going to have my cervix removed, it serves no real purpose. I will be having the sling to support the bladder and it only will cause me to continue Pap Smears and the possibility of Cervical cancer is still there. I may still have mini-periods.... SO the cervix is going... It is not like the ovaries that have a puirpose.... The ovaries are staying......

Good luck to you and you will do just fine. I am happy to hear that you have more confidence now. I think that is a big part of it - having faith in your doctors and in knowing you are making the correct decision, which you are. Keep us posted!