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Solutions for Stress Incontinence

By DuPage Medical Group Urology



What is the Purpose of a Urethral Sling?

Sling procedures help control stress incontinence, (urine leakage) that can happen when you laugh, cough, sneeze, lift things or exercise. They help close your urethra (the tube that carries urine from the bladder to the outside) and the bladder neck (the part of the bladder that connects to the urethra). Stress incontinence may be caused by weakened or damaged pelvic muscles and ligaments. These structures can be weakened by pregnancy, childbirth, trauma, radiation, prior surgery, muscle damage, or hormonal changes, causing the bladder and urethra to relax from their normal positions.

How it is done?

Your sling procedure will take an estimated 30-45 minutes. Your doctor will determine the type of anesthesia you will have during the procedure. Once the anesthesia takes effect, your doctor will begin the procedure. A small incision will be made in the vaginal area and two small incisions will be made through the skin in the groin area. Next, the synthetic mesh is placed. When it is placed, it will extend from one skin incision, in towards the vagina, around the urethra and back out through the second skin incision. This creates a “hammock” of support
around the urethra. Your doctor will adjust the mesh tension so that the leakage of urine is reduced. When your doctor is satisfied with the position of the mesh, he or she will close and bandage the small incisions in the groin area and the top of the vaginal canal. Before the procedure is complete, your doctor will inspect your bladder with the use of a cystoscope to make sure that there are no signs of bladder injury or other lesions inside your bladder. Your doctor will also insert a catheter in order to drain urine from the bladder.

Risks Associated with the Procedure

Risks of surgery include bleeding or infection, injury to the bladder or vagina, exposure of the sling material, continued urinary leakage and the inability to urinate after surgery requiring revision of the tension of the sling.

What to Expect After Surgery

In the recovery room, the nurses will remove the catheter in your bladder and test your ability to urinate. If you are unable to urinate, they will replace a catheter in your bladder and instruct you when to follow-up. You may have some vaginal bleeding or discharge for the first week after surgery. You may have some bruising along your inner thighs from the incisions for the sling
placement. You may also have some burning or irritated voiding initially after the surgery. Pyridium may be prescribed to help. This medication will turn your urine orange in color.



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