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Use of Slings for Incontinence

When you suffer from incontinence, various methods may be taken to treat your condition. In mild cases, medications and physical therapy may be all that is necessary to treat your bladder. However, if these less invasive techniques fail, you may need to resort to other options, such as the placement of a sling. While incontinence surgery has a risk of complications developing, in the long run, the outcome supersedes any possible difficulties. Various types of sling procedures are offered.

  1. Tension-Free Sling

    • A tension-free sling is made out of a synthetic mesh. A small strip of mesh is used to reinforce your ligaments and tissues that encase your urethra. In essence, this piece of mesh forms a sling around your bladder and the neck of your bladder. The sling helps to keep your bladder closed, and to prevent bladder from leaking if you cough or sneeze, or engage in strenuous activities. There are two types of tension-free sling procedures; retropubic and transobturator.

    Retropubic Procedure

    • When you undergo a retropubic procedure, three small incisions are made upon your body. One incision is made inside your vagina, and then two small incisions are made directly above your pubic bone. According to the Mayo Clinic, your surgeon uses a needle, which is holding your sling, to place the sling into position. The sling is placed between your pubic region and your bladder. Though stitches do not hold your sling into place, your incisions will be sutured.

    Transobturator Procedure

    • A transobturator procedure is somewhat like the retropubic procedure. However, instead of the sling being passed between your pubic bone and your bladder, a needle threads the sling near your labia and then strings the sling under your urethra. According to the Mayo Clinic, a transobturato procedure can lesson your chances of developing an injury to your urethra or bladder.

    Pubovaginal Sling

    • When you undergo a pubovaginal procedure, your surgeon uses a piece of your own skin to create the sling. An incision will be made above your pubic bone and inside your vaginal wall, The sling is threaded from your vaginal wall and then wrapped around your bladder neck. Sutures secure the sling above your pubic bone incision, which creates a support system for your bladder neck. According to the Urology Channel, it is possible to maintain bladder control with a pubovaginal procedure for up to 10 years.

    Adjustable Slings

    • Adjustable slings are slings that can have the tension adjusted according to your bladder control needs. After your sling is put into place, your surgeon will either increase or decrease the tension in your sling while you are awake. If you need your sling to be tightened over time, your surgeon can give you a local anesthetic, and adjust your sling once again.

    Risks

    • After initially receiving a sling procedure, it is common for you to temporarily develop urinary issues, such as difficulty in urinating, or the inability to empty your bladder. It is also possible to develop a urinary tract infection, accidental bladder puncture, bowel injury, and bleeding. It is also possible for sexual intercourse to become painful. If you begin to develop a fever and chills, nausea and vomiting, or abdominal cramping that doesn't subside, immediately seek medical attention, as this could be a sign of infection.

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