Difference between TVT and mesh bladder sling?

I had a hysterectomy for fibroid tumors in 2006. I have had increasing stress incontinence since then (if I cross my legs I can probably avoid leaking when laughing or coughing; if I trip with a full bladder it will empty down my legs). I now have to have my ovaries removed on Tuesday due to tumors (not sure if cancer or not yet) on them. I had already been assessed and approved for a piece of tape under my urethra -- the current doctor says it will be a TVT or TOT "depending" on what they see (not sure what that means. I have a lot of scar tissue from my hyster and appendectomy in 2007). I didn't do it because I didn't want another surgery -- but since I have to have my ovaries removed anyway, they said they will do the TVT or TOT at the same time.

So here is my question: I see the horrors over mesh uretheral slings listed on this site. Does the newest type of TVT or TOT surgery involve mesh? She definitely said a small piece of tape -- is that mesh? I can verify with my surgeon at 5 am on Tuesday when I arrive for surgery, but I'd like to be a bit more informed before I get there. Are there sisters with good results recently with this surgery? I'm having the surgery done at a huge University teaching hospital, and a uro-gynecologist will do that part of the surgery.....

Scared of not being able to pee or my body rejecting the mesh etc etc!

Tvt and tot both involve mesh. I believe the tape is the peice of mesh.I had a tvt in Feb 08 and had great results. My only problem was having a cath for four days. But I have had no problems what so ever. I know some people have had mesh erosion and other problems. I would research and read up on it. But just wanted to let you know I had no problems. Hope all goes well for you and a speedy recovery.

thank you, that does indeed help. I would love for people who had NO problems to post here (anyone with problems can too, of course)..... there are plenty of threads of problems, I would love to have a thread of NO problems, since I am sure there are plenty....

Beth
I've got a TVT and I can confirm that the tape is a little strip of mesh. There are 2 kinds of mesh - porcine and a synthetic one, so ask your surgeon what kind will be used. Larger amounts of mesh are involved when it is used in the anterior repair procedure to fix the front wall of the vagina. I think that more of the mesh erosion issues are associated with that procedure.
I've got no problems with the mesh and the TVT works beautifully. I can jump, cough, sneeze, laugh etc with no leakage at all. I've also stopped tensing in anticipation of it.

Would it be possible to phone your surgeon on Monday rather than taking this question into pre-op. Your an old hand so you know how stressful it is, but you'll have few choices at that point as the Dr won't be able to change anything e.g. to get a kit containing the other type of mesh on the spot.

All the best with this surgery. Remember most of us have NO problems, but they are less likely to be on the website.

Judy

Thank you judna, that is waaaay more info than I could find anywhere! So do I want the synthetic or the porcine? I may not have a choice, I am doing this with County health services (I've had lots of other issues I'm not going into) -- and is there a huge difference between the porcine and the mesh in case I don't have a choice?

I just went with my urogyn surgeon's advice on this and have synthetic mesh. If you put porcine mesh into the search box near the top right of the hystersisters page you'll get lots of posts. Many of them prefer to have the porcine but this is not quantified - what proportion of women have less issues with the synthetic mesh? Is it just 1 or 2 in 100 or 1000 or is it 10 or 20 or more? It is hard to make a good decision for your own body. Eventually you need to trust the professional judgement of your surgeon.

J

yes, good point. It is a scary decision to do this, because I am not up to the point where I need to wear pads, but I do get little leaks and if I trip with a full bladder it will empty. But since I will be under anesthesia already, if I'm going to EVER want to do it, I need to do it now. I think I am just going to do it.

Remember most ie 90% (as quoted by my surgeon) women have no problem with the mesh in the TVT or TOT.
Good luck for that final decision and for surgery on November 24th.
Judy

Hi Beth,

Thought I'd jump in as well. I have the TVT sling. I too had the catheter, five days I think. I had a number of UTI's in the first two months, which is fairly common, but the infections eventually stopped. At six weeks I still had stress incontinence, but the dr said to give it more time, especially in light of the UTI's. I'm happy to say that gradually the stress incontinence lessened and it's not an issue anymore.

Judy is right in that the vast majority do very well with the TVT. My recovery was a little problematic, but the problems were not major and eventually my body sorted it out and I am fine. It just took some patience.

Jeanne

Hello ispy:
I live in Canada, had a cystocele and rectocele repair with TVT (synthetic mesh) in Feb. 2009, experienced a quick recovery, went back to fulltime work after 2 weeks, and have had NO problems with any type of incontinence (stress or urge) since.