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Tuesday, November, 24, 2009
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tvt tape erosion

heather
06/12/09

How difficult is it to rmove an eroded tvt tape

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Answers (1)
Christine
Saturday, August 22, 2009

I think it is incredibly difficult and dangerous to remove eroded tape.  It can require multiple surgeries and I believe you will need vaginal and or urtheral reconstuction

Six years ago I was suffering from mild stress incontinence. At the suggestion of my (then) gynecologist who is an eminent lady professor practising in London I had a TVT inserted. Her name is Professor Linda Cardozo, 8 Devonshire Place. London W1G 6HP. TeL 020 7935 2357. I was not, at any time, told of any possible side effects, simply that she had already done 90 of these procedures very successfully. Had I been informed at the time that erosion was a possible side effect, at least I would have had the option to decide whether to undergo this procedure or not. I was quite ill after the operation but that is another story. During the six years when I had my yearly check up I usually had a urine infection and was told that this was because of my age and my low estrogen levels. I rather suspect that these infections may have been caused by the erosion taking place but I have no evidence of this.

Just before last Christmas I went to see her and said that something was wrong. She prescribed an estrogen cream and said she was sure this would work. My discomfort became steadily worse, the symptoms being sharp pain when I sat down suddenly; when urinating I felt as though I was peeing over razor blades, and excruciating pain on intercourse. In July I eventually saw another gynecologist who admitted me to hospital and did a cystoscopy. He discovered that the mesh had eroded into the urethra. I asked him to remove the mesh but he said he couldn't, as by now the tissue had grown around the mesh and it was now a difficult and dangerous operation. He recommended a Urologist who was removing mesh erosion by laser. Apart from the feeling of violation, I cannot even begin to describe the despair and anxiety I felt. This laser procedure had either not been heard of, or not recommended by the any of the medical profession I had been in touch with in America.

After further worldwide investigation, I came to the conclusion that the only alternative I had was the laser procedure. I went to see the Urologist who has done 5 of these operations in the last 18 months. 4 successfully, with the 5th having to be redone as the mesh re-eroded again quite quickly.

Anyway, the bottom line is that there seem to be two options at the moment: Remove the whole mesh via the vagina, and then urethra and vagina must be reconstructed with plastic surgery. It is really major surgery. Or removal of the erosion by the least aggressive way possible. The downside is that when mesh is endoscopically removed it can take several attempts to remove sufficient of the tape to relieve the symptoms. However, it seemed to me that the less trauma I have to go though the better.

I have opted for laser removal of the erosion . I had the procedure done last week which took 2 hours and a general anesthetic and am praying to God it doesn't erode again. I had a catheter in for 36 hours and then when I could urinate properly I was allowed go home. It would appear that the procedure has been successful but its early days yet and only time will tell. I will be having a scan in November or December to monitor my progress and will keep you posted.

I'm resting now as I feel exhausted, but if I can be of any help to anyone out there just contact me.

Kind regards and good luck

Christine

re: tvt tape erosion
dlinrich
Tuesday, November 17, 2009 at 09:49 AM

I had TVT operation in September and the tape, made by Coloplast, has eroded through the vaginal wall and was discovered 7 weeks later. I'm in pain and the area is now bleeding. My doctor is not sure what to do. I go back in next month for him to cut some away and do some plastic surgery to mend the eroded area. Should I have him remove the tape?

Any comment would help at this point. 

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re: re: tvt tape erosion
Christine
Tuesday, November 17, 2009 at 11:34 AM

Its a really difficult and dangerus operation to remove the tape.  I dont know where you are but I had my mesh erosion removed by laser as it was the only option open to me.  Can you locate a urologist who specialises in removing eroded mesh by laser? I had the prodedure in Jnne and so far I am OK.  I do know however, that if the mesh erodes again, then i'll have to have laser again.  If you are in the UK then I can let you know the name of the surgeon.

 

Kind regards and good luck

 

Christine

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re: re: re: tvt tape erosion
dlinrich
Tuesday, November 17, 2009 at 01:10 PM

Hi Christine,

 I'm in Massachusetts USA.

Is the mesh the same thing as the tape used in the TVT procedure?

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re: re: re: re: tvt tape erosion
Christine
Tuesday, November 17, 2009 at 01:26 PM

Yes I believe its the same thing.  Just a different manufacturer. Can you finds a urologist that specialises in laser?

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re: re: re: re: re: tvt tape erosion
dlinrich
Tuesday, November 17, 2009 at 01:49 PM

I am meeting with my gyn today. I will ask her.

Coloplast made the tape my doctor used. He has done this procedure for 10 years without erosion or problems but since he changed to Coloplast in August 3 out of the 5 he has performed have failed in the same manner.

He feels bad that he changed the material but the Coloplast salesman said that it too had a very low fail rate. I wish my doctor gave me the option to use the old or the new.

 I'm very upset. I WAS a competative triathlete and I'm getting married in June.

The thought of my honeymoon is no longer something to look forward to.

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re: re: re: re: re: re: tvt tape erosion
Christine
Tuesday, November 17, 2009 at 06:28 PM

I cant believe that your Doctor had no erosion problems in the 10 years he was doing this procedure, no matter which sort  of mesh he used.   All mesh erodes. I've been in contact with many women who are suffering from Erosion problems after a few month.

 

Have you though of changing your Doctor?

 

 

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re: re: re: re: re: re: re: tvt tape erosion
dlinrich
Tuesday, November 17, 2009 at 07:37 PM

My gyn said that she has not seen this erosion before either. She was the one who recommended me to him. She directed me to another urologist for a second opinion.

Since he has had 3 out of 5 fail in the past two months I wonder if it was not pulled tight enoght to begin with because I have had this pain in the suture area since day one. Do you think he could just trim it???

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re: re: re: re: re: re: re: re: tvt tape erosion
Christine
Wednesday, November 18, 2009 at 12:54 PM

I am not a Doctor so cant help you with that kind of advice.  I am just another patient who found herself in a similar situation to you.  I do understand how you feel as before the laser I was in constant pain and desperate for help.  There is a marvellous American website dealing with mesh erosion.  They are far more advanced than us here in the UK and have had conferences, and class action lawsuits against the manufacturers of the mesh.  I suggest you get in contact with them at meshcomplications.com

There was also a Professessor at Dallas that I found who seemed very kind and helpful, but knew nothing about the removal of erosion by laser.  You could contact him.   philippe.zimmern@utsouthwestern.edu

 

Let me know if I can be of any further help - Kind regards Christine

 

 

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