Bladder sling surgery can be a beneficial treatment for women that experience stress urinary incontinence and have not responded to other conventional treatment options. Bladder sling surgery aims to provide additional support to the urethra to prevent urine leakage.
What is Urinary Incontinence?
First, it’s essential to understand urinary incontinence and how it can affect women. This common condition affects women of all ages but is more prevalent in older women. Various factors, including childbirth, hormonal changes, and menopause, can cause urinary incontinence. Urinary incontinence can significantly impact a woman’s quality of life, causing embarrassment, social isolation, and decreased self-esteem.
Various incontinence products like protective underwear, adult diapers, pads, and liners can provide the absorbency and protection needed. However, if the problem is more complicated and persistent, alternative options may need to be discussed.
What is Bladder Sling Surgery?
Bladder sling surgery, sometimes referred to as urethral sling or vaginal sling surgery, is designed to treat women who experience urinary incontinence caused by weakened pelvic muscles. A small incision is made in the vaginal wall or abdomen, whichever the patient’s specific needs are, and a strip of synthetic mesh is implanted and positioned under the urethra, the tube that carries urine from the bladder out of the body. This mesh material acts as a sling or hammock and is then attached to the pelvic bones or tissues to hold the sling in place to support and prevent urine leakage. There are three main types of bladder slings.
Types of Bladder Slings
Tension-free vaginal tape (TVT)
This is the most common type of bladder sling. It is a minimally invasive procedure and involves the insertion of a mesh tape through a small incision in the vagina. This mesh tape is then threaded through the abdominal wall and anchored in place. The mesh tape acts as a sling, supporting the urethra and reducing urinary incontinence.
Transobturator tape (TOT)
This type of bladder sling is similar to the TVT, but less invasive, according to Baylor Medicine. The mesh tape is threaded through the groin area instead of the abdominal wall. This reduces the risk of injury to the bladder or other internal organs.
Mini-sling or single-incision sling
This type of bladder sling is a newer, even less invasive option. It involves the insertion of a small mesh sling through a single incision in the vagina to support the mid-urethra. According to a study, patients reported a lower pain score over the course of two weeks following mini-sling surgery than alternative surgery options.
Who Qualifies for Bladder Sling Surgery?
The qualifications for bladder sling surgery may vary depending on the individual case and the doctor’s recommendations. Generally, candidates for bladder sling surgery include women who:
- Have been diagnosed with stress urinary incontinence
- Have tried conservative treatments such as pelvic floor exercises, medication, or pessaries but did not see improvement
- Do not plan to have children in the future, as pregnancy and childbirth can undo the benefits of the surgery
- Do not have any medical conditions or other factors that may increase the risk of complications during or after surgery, such as obesity, smoking, or chronic health conditions
- Have realistic expectations of the surgery’s outcome and are willing to comply with post-operative care instructions
Potential Risks and Complications
As with any surgical procedure, bladder sling surgery does carry some risks, including bleeding, infection, and complications with the mesh or sling. However, the success rate for this procedure is high, and most women experience a significant improvement in their symptoms. Recovery time varies from patient to patient, depending on their overall health and the extent of the surgery, but most women can resume normal activities within a few weeks after surgery.
What to Expect After Sling Surgery
After the surgery, you will stay in the hospital for a day or two to recover. During this time, you will be given pain medication to manage any discomfort, and you may need to use a catheter to help drain your bladder temporarily.
Avoiding strenuous activity or heavy lifting for at least six weeks after the surgery is recommended to allow your body to heal properly. You may also need to avoid sexual intercourse during this time.
If you have unsuccessfully exhausted all conventional efforts to manage your urinary incontinence, discussing sling surgery with your doctor may be beneficial. It is essential to discuss your medical history, current health status, and goals with your doctor to determine if you are a suitable candidate for bladder sling surgery.