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British Association of Urological Surgeons (BAUS), Risks & Complications

British Association of Urological Surgeons publish Leaflet describing Risks of TVT

In March 2011, the MHRA held a workshop to consider how to make insertion of TVT, TOT or other types of synthetic mesh “a safer procedure”.  As a result of this workshop, the British Association of Urological Surgeons  published a patient information leaflet, which it claimed would supplement any advice patients may already have been given by their GP or other healthcare professionals.

To see a copy of the leaflet, click on link: http://www.baus.org.uk/Resources/BAUS/Documents/PDF%20Documents/Patient%20information/Sling_female.pdf

The leaflet, which explains that the “tape will remain in the body forever”, describes the risks of synthetic vaginal tapes for stress incontinence as follows:

Common (greater than 1 in 10)

  • Need to go to the toilet frequently, due to a feeling of having to rush (urgency) and, sometimes, with urine leakage due to urgency. Often, you will have experienced this before the procedure as well
  • Failure to improve urinary incontinence so that you still have bad leakage (some women still have mild leakage)
  • Inability to empty the bladder completely so that you need either to keep a catheter on all the time or you need to use a catheter several times a day to empty the bladder (intermittent self-catheterisation)
  • Infection
  • Slow urine flow
  • Recurrence of urinary incontinence; this can happen years after the tape has been inserted at later time
  • Pain: you will get some discomfort/pain for a while, usually where the skin was cut during the operation. TOT can cause thigh or groin pain. This can be relieved by simple painkillers in most cases but there are occasions where more powerful drugs are needed

Occasional (between 1 in 10 and 1 in 50)

  • Injury to the bladder during the TVT operation; the risk is much less for TOT surgery
  • Misplacement of the tape; this should be discovered at the time of surgery and the tape re-positioned correctly
  • Injury to surrounding tissues (e.g. bladder, rectum and blood vessels)
  • Erosion and migration of the tape into the vagina, bladder or urethra; this can happen several years after the tape was inserted. Symptoms such as recurrent urinary infection, change in urinary symptoms, vaginal discharge and discomfort during intercourse may occur

Rare (less than 1 in 50)

  • Reaction to the sling material (inflammation, infection or allergic) requiring removal

The leaflet explains what you should look out for after having this procedure.  For example, If you find it increasingly difficult to pass urine, or if you develop symptoms of a urine infection (burning, frequency and urgency), you should see your doctor promptly.

You should seek help from your doctor if you experience:

  • severe vaginal bleeding
  • severe abdominal pain or swelling
  • foul-smelling discharge from the wound
  • high fever (you should take your temperature if you suspect this)
  • pain when passing urine
  • difficulty in passing urine
  • pain or swelling of the calves

Alternatives to TVT & TOT

The leaflet mentions that there are alternative treatments and these can be discussed in more detail with your Surgeon or Specialist Nurse.

Give your Views

Please note that it is not clear whether patient groups have been involved in the production of this leaflet.  Do you feel that the leaflet emphasises the risks adequately?  Should the leaflet refer to the growing controversy surrounding synthetic mesh implants, so that women are fully informed?  If you feel that there are ways in which this leaflet could be improved to give better and more accurate information to women considering surgery, then you could write to the British Association of Urological Surgeons at the following address:

The British Association of Urological Surgeons Ltd
35-43 Lincoln’s Inn Fields
London, WC2A 3PE

Alternatively, you could email them using the on-line form: http://www.baus.org.uk/AboutBAUS/Contact-details

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