Vaginal Sling

A vaginal sling is a medical procedure used to treat stress urinary incontinence by creating a hammock of support beneath the urethra to prevent it from opening when you cough, sneeze or laugh. Stress urinary incontinence — leakage of urine with physical activity, such as exercise, coughing, laughing or sneezing — is a common problem for women that is caused when the urethra drops out of place or by a weakening of the sphincter muscle that controls the urethra as a result of pregnancy, childbirth or aging. Sometimes it can be treated successfully without surgery, but other times surgery may be the best treatment option.

Vaginal Sling

Urodynamic tests can be done to determine the best course of treatment for your type of incontinence. In such tests, a catheter is inserted through the urethra and into the bladder to check urethra and bladder function. If the testing indicates that you may be helped by a sling procedure, a transobturator approach is attractive because it has a high success rate and a low complication rate.

The procedure involves a small incision in the vagina, beneath the urethra, and two small groin incisions just outside the labia majora. A mesh, tension-free vaginal tape is passed through a space called the obturator foramen to form a hammock under the urethra. The tension-free tape is not attached by sutures, but stays in place by holding on to the surrounding tissues. The healing process allows your own tissue to grow into the mesh, keeping it securely in place.

The procedure takes about 30 minutes and is usually done under a general anesthetic, though it also can be done with a local anesthetic and sedation. There is very little post-operative pain, but it is important to refrain from heavy lifting or vigorous physical activity for 6-8 weeks after your surgery to allow proper healing.

Success Rate

This procedure has an 85- to 95-percent success rate.

Potential Complications

  • Bleeding and blood clots
  • Infection
  • Damage to the urethra or bladder
  • Mesh erosion

Alternative Procedures

  • Vaginal pessaries
  • Bulking agents
  • TVT retropubic sling
  • Laparoscopic procedure
  • No treatment

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