Urinary incontinence - vaginal sling procedures

Definition

Vaginal sling procedures are types of surgeries that help control stress urinary incontinence. This is urine leakage that happens when you laugh, cough, sneeze, lift things, or exercise. A vaginal sling procedure helps close your urethra and bladder neck. The urethra is the tube that carries urine from the bladder to the outside. The bladder neck is the part of the bladder that connects to the urethra.

Alternative Names

Pubo-vaginal sling; Transobdurator sling

Description

Vaginal sling procedures use different materials:

You have either general anesthesia or spinal anesthesia before the surgery starts.

A catheter (tube) is placed in your bladder to drain urine from your bladder.

The doctor makes one small surgical cut (incision) inside your vagina. Another small cut is made just above the pubic hair line or in the groin. Most of the procedure is done through the cut inside the vagina.

The doctor creates a sling from the tissue or synthetic material. The sling is passed under your urethra bladder neck and is attached to the strong tissues in your lower belly.

Why the Procedure Is Performed

Vaginal sling procedures are done to treat stress urinary incontinence.

Before discussing surgery, your doctor will have you try bladder retraining, Kegel exercises, medicines, or other options. If you tried these and are still having problems with urine leakage, surgery may be your best option.

Risks

Risks of any surgery are:

Risks of this surgery are:

Before the Procedure

Tell your doctor or nurse what medicines you are taking. These include medicines, supplements, or herbs you bought without a prescription.

During the days before the surgery:

On the day of the surgery:

After the Procedure

You may have gauze packing in the vagina after surgery to help stop bleeding. It is usually removed a few hours after surgery.

You may leave the hospital on the same day as surgery. Or you may stay for 1 or 2 days.

The stitches (sutures) in your vagina will dissolve after several weeks. After 1 - 3 months, you should be able to have sexual intercourse without any problems.

Follow instructions about how to care for yourself after you go home. Keep all follow-up appointments.

Outlook (Prognosis)

Urinary leakage gets better for most women. But you may still have some leakage. This may be because other problems are causing urinary incontinence. Over time, the leakage may come back.

References

Appell RA, Dmochowski RR, Blaivas JM, Gormley EA, et al. Female Stress Urinary Incontinence Update Panel of the American Urological Association Education and Research. Update of AUA guideline on the surgical managementof female stress urinary incontinence. J Urol. 2010;183:1906-1914.

Dmochowski RR, Padmanabhan P, Scarpero HM. Slings: autologous, biologic, synthetic, and midurethral. In: Wein AJ, Kavoussi LR, Novick AC, et al., eds. Campbell-Walsh Urology. 10th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 73.

Wai CY. Surgical treatment for stress and urge urinary incontinence. Obstet Gynecol Clin North Am. 2009;36:509-519.


Review Date: 12/12/2012
Reviewed By: Louis S. Liou, MD, PhD, Chief of Urology, Cambridge Health Alliance, Visiting Assistant Professor of Surgery, Harvard Medical School. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, David R. Eltz, Stephanie Slon, and Nissi Wang.
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