Health Organization for Pudendal Education

I have a Tarlov Cyst which is pressing on the S2-S3 nerves causing Pudendal Neuralgia among other symptoms. I am have a lot of bladder incontinence, and my gynocologist said that he could do a TOT bladder sling procedure which could solve the problem. But even though he said that it would not affect the pudendal nerves, I fear that it might. Has anyone with PN had this procedure done? What was the effect? Thank you for any information you could give!

I had a TOT and it was a nightmare! It was too close to the obturator nerve and I have pretty good nerve damage to the obturator nerve on the right side. I have had two surgeries to remove the sling from the pelvis but there is still sling in the adductor muscles of the legs. Intercourse was impossible with the sling as I had one spot in my vagina that couldn't be touched once the sling came out that spot has been gone (thank God). The usual complications seen with TOT slings are 1) vaginal erosion, 2) groin pain and 3) inability to void.

It is hard to say whether the TOT is what caused my PN or the hysterectomy or a combination of both. The surgery who did my sling I found out at a later date had only put in about 6 slings before mine so he was relatively new at the procedure. My current gyn actually works on the side for Boston Scientific(One of the TOT sling manufacturers) and told me that even with all his experience that occasionally he has had a woman complain of groin pain. There is a new type of sling out that is similar to the TOT but it doesn't go into the obturator foramen and he told me that since he switched to this sling he has had no groin pain. I don't know the name of the sling. No worries about catching the obturator nerve if you don't go into the obturator forum. However, there are 25% of women whose clitoral branch could be caught by the pduendal nerve if it isn't put in exactly correctly just due to the natural variation of the pudendal nerve. This is a communication I had with a physician in Switzerland (forget his name) about 4 years ago, I've never seen the publication.

Some of the key questions are how many TOT slings has he done before? Anyone have any type of complication, esp. the ones listed above? If so, how does he treat them? Does he do other types of slings? The more types of slings he has done the better because he is more familiar with the pelvic floor. Some gyn's are doing the TOT now because it is suppose to be "error proof" and they never did other types of slings previously such as the old standard Burch.

PM if you want to talk.

The following is a link from WebMD regarding mesh slings:
http://www.webmd.com/urinary-incontinen ... wmh_071311

I forgot to add that the FDA has sent out warnings on TOT and TVT slings due to complications. One manufacturer had such high erosions rate that they voluntarily removed the product from the market a couple of years ago.

http://news.injuryboard.com/lawsuit-men ... eid=262464