Treatment or Urinary Incontinence
A midurethral sling procedure is designed to help women with stress incontinence.
Stress incontinence is the loss or leakage of urine while straining. This can happen with everyday activities including coughing, sneezing, jumping, lifting, exercise, or any activity associated with straining.
It can range from a mild inconvenience for some to a persistent and severe disruption of daily activities.
While losing urine is not life-threatening, it can be life-altering.
Midurethral Sling Procedure
The procedure is a minimally invasive technique that uses needles to place a narrow ribbon of mesh under the urethra. A midurethral sling system is designed to inhibit urethral dropping during physical activity including laughing or lifting.
The synthetic retropubic midurethral sling has been extensively researched. The Food and Drug Administration (FDA) supports the safety and effectiveness of midurethral slings, which have largely replaced older, more traditional procedures for stress urinary incontinence.
- Midurethral sling surgery usually takes less than 30 minutes to perform.
- It is an outpatient procedure, meaning that you usually can go home the same day.
- Recovery time generally is quicker than with other procedures for SUI.
- Success rates
- Synthetic retropubic midurethral slings have extraordinarily high success rates. Numerous high quality national and international studies have demonstrated efficacy greater than 90%.
Synthetic midurethral slings are not recommended if you want to get pregnant in the future.
On the day of the surgery:
- Do not drink or eat anything for 6 to 12 hours before the surgery.
- Take the medicines you have been told to take with a small sip of water.
- Arrive at the outpatient surgery center one hour prior to scheduled timer.
Procedure
- A small incision in the front wall of the vagina over the mid urethra.
- Two small incisions will be made location depends on the type of procedure:
TVT (Tension-free Vaginal Taping)
The incisions are made in the lower part of your belly (abdomen), near the pubic hairline
OR
TOT (Transobturator Taping)
The incisions are made in the in the inner upper part of your thighs.
- Through the incisions a mesh tape is placed like a hammock under the urethra.
- The 2 ends of the tape emerge through the incisions.
- The tape is placed tension-free, and the incisions are closed.
- The healing process holds the tape in place.
Recovery
During recovery, discomfort may last for a few days or weeks.
Avoid any activity that might put stress on the surgical area, including:
- Excessive straining
- Strenuous exercise
- Heavy lifting
What are the risks of a sling procedure?
There are a few risks involved in midurethral sling procedures, as with all surgical procedures:
- Injury to the bladder, bowel, blood vessels, or nerves
- Bleeding
- Infection of the urinary tract
- Difficulty urinating or other urinary problems
- Some patients may discover that it is more difficult to urinate after surgery or that urination is slower.
- Some find they may need to use a catheter during recovery.
- In rare cases, the stitches or the sling itself may need to be adjusted or removed if voiding becomes too difficult.
- If synthetic mesh is used, there is a small risk (less than 5 percent) that the mesh will erode through the vaginal tissue.
- Mesh erosion can cause long-lasting pain, infections, and pain during sexual intercourse.
- Additional surgery may be needed to correct the problem.