Facebook Pixel

Comment Reply

I found another interesting article (I can not verify the credibility of this information from this site; please confirm with your doctor):
http://www.femalepatient.com/html/arc/sel/may02/article04.asp

"Compared with cadaveric tissue, synthetic slings are associated with higher rates of erosion and infection. The Female Stress Urinary Incontinence Clinical Guidelines Panel of the American Urological Association observed that the use of synthetic material for slings is associated with an increased complication rate, including vaginal and urethral erosions and wound sinus formation.5The risk of these complications depends on the particular material used, although certainly surgical technique plays a role as well. While Gore-Tex slings have been associated with a high rate of erosion, requiring removal of the sling in up to 22% of patients,13other synthetics (eg, Mersilene mesh) confer a significantly lower risk of vaginal erosion. In a study of 110 women who underwent suburethral sling placement using Mersilene mesh, only one patient (0.9%) required excision of an eroded sling.14Although the Clinical Guidelines Panel reported that these complications occurred at rates below 1% (excluding certain high-risk synthetics), they can be troubling to patient and physician alike. Overall, serious complications arising from sling erosion into the bladder or urethra are rare."

"Although bladder and urethral erosions have been reported most commonly with synthetic slings,15they may also occur with fascial slings, and should be considered when women present with repeated urinary retention or irritative symptoms.16Cystoscopy should be performed if these symptoms are persistent, even if the test results were normal at the time of the surgery."

"Small vaginal sling erosions (less than 5 mm) that do not appear to be infected may respond to conservative treatment with topical estrogen alone, or with trimming of the visible sling and cauterization of granulation tissue. Larger erosions may be treated with excision of the exposed sling and reapproximation of healthy vaginal wall flaps (created by undermining the epithelium) with absorbable suture."

"More recently, tension-free vaginal tape, TVT, has gained popularity as a minimally invasive sling procedure that uses Prolene mesh to support the midurethra. Although long-term data regarding TVT are lacking, few vaginal erosions have been reported, which may in part be a function of the minimal dissection (and resultant minimal devascularization) required to properly place the sling."

August 17, 2010 - 9:00pm

Reply

Image CAPTCHA
Enter the characters shown in the image.
By submitting this form, you agree to EmpowHER's terms of service and privacy policy