Before undergoing bladder sling surgery, there are a few things for patients to consider. First, they need to ensure that their diagnosis is accurate. Seeing a urologist, or similar specialist, prior to committing to the surgery is an ideal option. For women, if they wish to bear more children, they may consider waiting to have the surgery. If someone gets pregnant following sling surgery, it may undo the surgical fix due to the strain of pregnancy and delivering a baby.
Lastly, patients should have realistic expectations. This surgery is not ideal for all types of urinary incontinence. For example, it may not work well for overactive bladder, but can potentially benefit stress incontinence.
There are tension-free and conventional slings that a doctor might discuss with their patient. While there are some other options, these are among the most commonly performed. To create the sling, the surgeon may use the patient’s own tissue, donor tissue, synthetic mesh, or animal tissue to essentially create what resembles a hammock. This helps to keep the urethra closed while supporting it. This helps to prevent the leakage of urine.
A tension-free sling is generally made from synthetic mesh tape. It is stopped from moving after scar tissue forms. There are three different approaches used:
Transobturator is characterized by a vaginal incision that is created just below the urethra. This type also involves small incisions on either side of the labia. The sling goes under the urethra and the incisions are closed.
Retropubic also involves the same vaginal incision, but the secondary incisions are above the pubic bone. The sling goes behind the pubic bone and under the urethra. Then, the incisions are closed.
Single-incision mini involves only one vaginal incision. The sling then goes under the urethra. After placement, the incisions are closed.
The average recovery time is two to four weeks, but the exact procedure performed, and the patient’s overall health will determine the exact healing time.
The conventional approach can use tissue or synthetic mesh. The incision is made into the vagina and another in the abdomen. The sling is attached to the abdominal wall and the pelvic tissue with stitches. The incision for this option is larger compared to the tension-free choices. Recovery might also take longer, require a short hospital stay and require a temporary catheter.
All surgical procedures come with risks. The following are considered uncommon, but patients should still be aware:
Temporary urinary retention and difficulty urinating