Vaginal Sling (TVT) Complications

Vaginal Sling (TVT) Complications

In April of 2024, I underwent TVT urethral sling with permanent mesh surgery due to severe bladder incontinence issues (resolved). Two weeks post op, I started experiencing mobility and pain issues (burning, dull, radiating and muscle spasms) on the left side of the groin and inner thigh. Walking was painful, range of motion limited and sitting needed to be at a reclined position (to present). It was determined the obturator, obturator internus and genitofemoral nerves were impacted and the left arm of the sling needed to be removed. Following removal, the pain resumed 8 days post op. I was then seen by another urologist who determined tenderness around the left hip area with pain was coming from the left psoas muscle on palpitation. He advised the delay in pain following both surgeries was a function of the anesthesia taking longer to wear off and referral made to a pain specialist. The pain specialist confirmed left groin pain extending to the left side of the vagina, left anterior and medial aspect of the thigh. He completed botox injections into the psoas, obturator internus and numerous nerve block injections into the genitofemoral and obturator nerves. These blocks either backfired causing unbearable pain or if relief was experienced, it did not last beyond 13 days. The pain specialist verbally sited trauma was likely caused during the initial surgery resulting in the pain and mobility issues.

From late July 2024 – to present the following tests have been completed;

December 2024 - MRI of left hip showed a diminutive and blunted appearance of the anterosuperior, superolateral and posterosuperior acetabular labrum. This may be secondary to a remote healed labral tear on the left hip.

February 2025 - EMG by the Trauma Rehab Institute SPARC Program indicated there was L3/L4 root involvement.

August 2025 - MRI of lumbar spine showed disc bulge with superimposed left subarticular disc protrusion at L4­L5 contacting the traversing left L5 nerve root with no significant foraminal or spinal canal narrowing.

October 2025 – Ultrasound of Hip – Showed severe bursitis and a cortisone injection into the hip and SI joint was completed. Ultrasound to be repeated in February 2026.

December 2025 - MRI of pelvis showed no intrapelvic compressive mass along the track of the obturator nerves. Left-sided 3.9 x 3.6 x 2.7 cm simple ovarian cyst with trace amount of free pelvic fluid and small hemorrhagic/proteinaceous content Bartholin cyst. No focal edema or focal enlargement of the portion visualized of the obturator nerves. Slight increased signal and thickened appearance of the pudendal nerve on the left side at the level of the sciatic notch this appearance appears to be explained by an adjacent small vessel adjacent to the nerve in this location without signaling abnormality of the nerve itself.

Proactive measures I have taken to date looking for answers;

- From late July 2024 – to present – Seen by an Osteopath, Physiotherapist (including pelvic floor), Chiropractor, Massage Therapist, complete acupuncture and use a TENS and Red-Light Therapy Belt. To date, all treatments are continued apart from the Osteopath where zero relief occurred. Physio and Chiro have identified issues stemming from the following areas; Glut Med/Max, Piriformis, Adductor, Abductor, Obturator Externus, Pubovaginalis, Iliopsoas, Gracilis, Sartorius and Medius. Assessments/Weekly Treatments have shown; pain with internal rotation left hip, pain with adduction left hip, pain with hip flexion, continued pain to left psoas on palpitation, decreased movement left SI joint, coccyx pain, increased tone left glut med/max piriformis, Increased edema left lateral aspect and increased edema/pain upon palpitation within the pubovaginalis with spasms occurring to surrounding areas.

- Consulted a specialist out of the USA who upon reviewing my file, agreed something must have occurred during the initial surgery to create the post surgical complications. He in addition suggested an EMG be completed and an Orthopedic Surgeon be seen to rule out anything from an Orthopedic perspective (completed).

- The Orthopedic Team at Women College Hospital reported there was a multifactorial cause of the left sided hip and back pain with no tenderness to the right. The left hip was quite irritable with logroll, flexion abduction, internal rotation and flexion abduction external rotation. The site of irritation also moved around the hip on these maneuvers completed on the left side. Requested a left hip intra-articular steroid injection for diagnostic purposes be completed and pain was only decreased for 12 days.

- Part of Women’s College Hospitals TAPMI program whose assessment showed the pain is likely an injury which occurred to the genitofemoral nerve given the distribution, and/or obturator nerve entrapment. It could also be a result of extreme positioning of the left leg during the initial surgery. The myofascial pain is likely secondary to posterior and dynamic changes from the primary injury. Pudenial Neuralgia highly likely.

- A large variety of medications have been prescribed and attempted since last April 2024 with the following being the most recent; Pregabalin, Duloxetine, Tramadol, CBD and THC. Supplements include; Magnesium to regulate bowels/reduce pelvic pressure, Turmeric/Curcumin and Omega-3 for inflammation as muscle relaxants were not helping.

I am hoping someone sees this post and can provide some kind of guidance. The last 20 months have been extremely difficult physically, mentally and emotionally. What was supposed to be a straight-forward TVT procedure with a 4–6-week recovery has been life altering. The version of me that use to be very active and always on the go with my two girls and husband now can’t handle a 20-minute walk around the neighborhood without having a flare-up or needing to take a break/cane. A simple task like making meals, cleaning the house, running errands or being an uber driver to my kids proves challenging. Every decision needs to be thought through based on my situation, how I’m feeling or if I can handle it. As a result of these complications, I have not been able to work and the path I imagined for myself at 41 years old, now revolves around mobility issues and daily chronic pain.