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Bladder Sling Case Evaluation

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Bladder Sling

Bladder-sling surgery is used to treat urinary incontinence in women. It involves placing of a sling around the urethra with an aim to place it in its regular position and put pressure on it to help in urine retention. The sling is typically made of a synthetic material such as polypropylene, which is supposed to be compatible with body tissue. This surgery was introduced in the 1990s, and has been used commonly to treat stress urinary incontinence (SUI) since then.

While a successful bladder-sling surgery can improve the quality of life of the patient, ever since the procedure was introduced, it has resulted in a large number of patients complaining of severe post-surgical complications. Many patients have had to undergo debilitating revision surgeries in order to remove a faulty bladder-sling device. As a result, many patients and doctors now consider it a much riskier procedure compared to traditional surgeries.

Risks Associated with Bladder Sling Surgery

Complications arising out of bladder slings made from mesh are often serious and painful, causing considerable physical and emotional distress to the patient. Multiple revision surgeries and other treatments may have to be undertaken to address the complications caused by this procedure. Many patients complain of difficulties in passing urine, new symptoms of incontinence such as urgency of urinating, infections at staple sites and injury or internal bleeding in an organ.

In more severe cases of complications, the synthetic sling may erode into the nearby organs located in the pelvic cavity. Organ perforation may also take place in some cases, if the sling punctures the organ. If the patient’s body rejects the sling, it may lead to inflammation which basically means pain and discomfort. Another risk is mesh contraction, which can cause painful sexual intercourse and severe pelvic pain which make sexual relations difficult.

Recovery after bladder-sling surgery is usually prolonged and painful. The patient may not be able to urinate on her own for many weeks, and will have to rely on a catheter. Constipation may be experienced for some time following the surgery. The patient must avoid the lifting of heavy weights for at least three months after the procedure. Sexual intercourse should also be avoided until the stitches dissolve, which can take up to two months.

Revision Surgery

Severe post-surgical complications in case of bladder-sling surgery may leave the patient with no other option but to undergo revision surgeries to have the defective transvaginal mesh removed. In a majority of cases, multiple corrective procedures may be required in order to remove the mesh completely. Mesh removal is not an easy task, and in some cases, total removal may not happen even after multiple surgeries.

The nature of the complication will determine the type of corrective surgery. Typical complications that necessitate revision surgeries may include mesh erosion and extrusion, obstruction of the urethra, fistula, injuries to nerves or blood vessels or injuries to the bladder or bowel. The U.S. Food and Drug Administration (FDA) has already received thousands of adverse event reports related to faulty mesh. While all patients have not required revision surgery, many of them have to undergo three or more surgeries to return to normal.