Anon, I'm so sorry about the situation you're in, and the anxiety you're feeling.
For those who may not know, TVT stands for "Tension-Free Transvaginal Tape," and it is a version of sling support for incontinence. It is done laparoscopically. A mesh-like tape is surgically inserted through the vagina to support the neck of the bladder and the urethra. The procedure alleviates stress-induced incontinence (like when you cough, sneeze or laugh) caused by weakness in the urethra. The tape that is used in the TVT procedure is called PROLENE(TM) polypropylene mesh tape, and it is fashioned into a sling that directly supports the urethra.
Here's one site that shows diagrams of the procedure:
http://www.miklosandmoore.com/tvt2.php
The procedure is not that old. It apparently was introduced in Sweden in the mid-'90s and in the United States in the late '90s. With your surgery being six years ago, I am wondering if they had had enough long-term use of the tape in order to study it to learn about such things as the erosion of the tape.
Here is a 2007 medical journal study on some developing long-term side effects of TVT. It is a little scientific and therefore you have to read it carefully, but it does have a section where it talks specifically about the erosion. Scroll down to the section titled "Erosion and Bladder Perforation":
It calls erosion "a rare but alarming delayed complication," so you are right to be concerned. The patients in this study that had surgery for this numbered just 5. Of those 5, four had the tape taken out and one was kept under observation. In 10 other patients in another study, "three were managed without surgery, four had the vaginal mucosa resutured over the exposed tape, and two required tape excision. Continence was preserved in all."
That last sentence is really important -- all the women experiencing this in those two samples did keep their urinary continence.
I need to understand a little more about "removing the erosion." Can you tell me just what the surgeons told you? I guess I am not understanding exactly what the difference is between removing the erosion and removing the tissue around the tape.
This next link basically links you to more studies on urethral erosion after using the mesh tape. They are all extremely medical and what I'm suggesting you do here is click on the "cross ref" boxes, print out the paragraphs that come up, read them and also ask your doctor about them:
I wish I could find you more information that was not quite so technical. Please write back and tell us more of what your surgeons have told you about the erosion and exactly what they plan to remove. I understand that they will leave the mesh intact but what do they say about the long-term effects here?
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Anon, I'm so sorry about the situation you're in, and the anxiety you're feeling.
For those who may not know, TVT stands for "Tension-Free Transvaginal Tape," and it is a version of sling support for incontinence. It is done laparoscopically. A mesh-like tape is surgically inserted through the vagina to support the neck of the bladder and the urethra. The procedure alleviates stress-induced incontinence (like when you cough, sneeze or laugh) caused by weakness in the urethra. The tape that is used in the TVT procedure is called PROLENE(TM) polypropylene mesh tape, and it is fashioned into a sling that directly supports the urethra.
Here's one site that shows diagrams of the procedure:
http://www.miklosandmoore.com/tvt2.php
The procedure is not that old. It apparently was introduced in Sweden in the mid-'90s and in the United States in the late '90s. With your surgery being six years ago, I am wondering if they had had enough long-term use of the tape in order to study it to learn about such things as the erosion of the tape.
Here is a 2007 medical journal study on some developing long-term side effects of TVT. It is a little scientific and therefore you have to read it carefully, but it does have a section where it talks specifically about the erosion. Scroll down to the section titled "Erosion and Bladder Perforation":
http://www.bcmj.org/reported-complications-tension-free-vaginal-tape-procedures-review
It calls erosion "a rare but alarming delayed complication," so you are right to be concerned. The patients in this study that had surgery for this numbered just 5. Of those 5, four had the tape taken out and one was kept under observation. In 10 other patients in another study, "three were managed without surgery, four had the vaginal mucosa resutured over the exposed tape, and two required tape excision. Continence was preserved in all."
That last sentence is really important -- all the women experiencing this in those two samples did keep their urinary continence.
I need to understand a little more about "removing the erosion." Can you tell me just what the surgeons told you? I guess I am not understanding exactly what the difference is between removing the erosion and removing the tissue around the tape.
This next link basically links you to more studies on urethral erosion after using the mesh tape. They are all extremely medical and what I'm suggesting you do here is click on the "cross ref" boxes, print out the paragraphs that come up, read them and also ask your doctor about them:
http://www.springerlink.com/content/l0276j4q66552075/
This last one is about laparoscopic removal of an eroded sling:
http://www.liebertonline.com/doi/abs/10.1089/end.2007.0008
I wish I could find you more information that was not quite so technical. Please write back and tell us more of what your surgeons have told you about the erosion and exactly what they plan to remove. I understand that they will leave the mesh intact but what do they say about the long-term effects here?
June 30, 2009 - 4:52pmThis Comment
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