Complications One Year After Mid-Urethral Slings in Sweden: Women's Perspectives
"Explore the aftermath of mid-urethral slings in Sweden through women's feedback one year post-surgery. Uncover insights on urinary problems, pain, impact on sexuality, and more. Discover the study's aim, method, and main clusters identified. Delve into personal accounts reflecting challenges and concerns post-surgery."
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Presentation Transcript
Complications one year after mid urethral slings in Sweden: What What the the women women say say Stefan Zacharias, MD Hudiksvall Eva Uustal, MD, PH D Link ping
Conflict Conflict of of intrest intrest Stefan Zacharias is the register manager for incontinence, GynOp Eva Uustal is the register manager for perineal tears and prolapse, GynOp The study is financed by the GynOp register
Aim of study What do the women write when they give their doctor their opinion about the surgery?
Method: Quantitative content text-analysis, clustering* GynOp questionnaire one year after MUS Quantitative data described earlier Unlimited space for free text answers from women Designed primarily for feedback to surgeons *Espinoza(2018). Analysis of Open Answers to Survey Questions through Interactive Clustering and Theme Extraction . CHIIR 18. doi:10.1145/3180000/3176892/p317-espinoza.pdf
Main clusters Urinary problems Pain Sex Infections Exposure, scarring
Urinary Urinary problems: problems: retention, retention, leakage leakage, , urgency urgency I had problems at once after surgery. Couldn t pee and had to use a catheter. I still can t pee. Can t pee while sitting, I have to stand up to be able to empty my bladder. I use diapers, my urine runs all the time. Before the surgery I leaked while exercising, sneezing or coughing. Now if I do not void immediately I pee my pants.
Pain Pain Pain 24-7 mostly on the left side. Sensitive to tight clothes, they give more pain. At certain positions when I sit or lift my leg, pain strikes my groin. I am always affected by the pain. I have difficulties to sit. Feeling of pressure over the urinary tract. Feels like the tape is pulled. Pain towards my legs, stomach and sides. Can t feel when I have to pee anymore. I mostly need to lie down because I have difficulties to sit. My life has become very limited due to the operation. Did you hammer nails into my pelvis? I can hardly sit.
Influence Influence on on sexuality sexuality I leak a lot of urine during intercourse. It is very embarrassing and I stopped having sex. I did not have these problems before the surgery. I am terribly sad about that. Don t want to stop having sex at the age of 47. My sexlife is much worse now. Since the operation I have difficulties to orgasm. During intercourse it hurts. The scars also make it difficult for me to satisfy myself. I thought many times that if I had known about the consequences for my sexlife I would have declined the operation. I have no more sensation in my vagina. Don t feel anything during intercourse. Spontaneous orgasms at night for 6 months after the surgery. That passed over time.
Recurring Recurring infections infections Since the surgery I had 12 urinary tract infections in 6 months. As soon as I stopped taking antibiotics it came back. Then I got a 90 day treatment with antibiotics. After that I had only two urinary tract infections. Countless urinary tract infections, I suppose because of the difficulties I have emptying the bladder.
Mesh Mesh erosion erosion I have 2 TVT slings lying open. Can feel it, its sharp and scratches. These tapes prevent me from leading a normal life. The sutures opened up and a bit of plastic could be seen in the vagina. I had another operation and after that something bulges in my vagina. Sometimes pain during intercourse. A sharp feeling down there. I got strange discharge, sometimes bloody that I didn t have before. Once, on the toilet I noticed a blue fragment.
Mixed Mixed comments comments Mental crisis because my clear wish for a female surgeon was not respected. Nightmares and psychological problems as consequence. Heavy bleeding, laparotomy, 12 days hospital care. See my journal for details. Complications occured during operation. First a bladder perforation led to reoperation in general anesthesia. Now I have a 9cm scar from the navel and downwards. There is a bubble-like thing near the navel that will be checked by a surgeon.
Qualitative analysis of womens experiences can teach us valuable lessons The treatment of some women suffering rare complications seems suboptimal The preoperative counselling in regard to rare complications can be improved Conclusions Conclusions
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