Female Sling Implantation
Female Sling implantation is the standard surgical treatment for stress urinary incontinence in women. Slings provide support to the pelvic floor muscles and help the urethra to better resist pressure from a full bladder. Slings are placed under the urethra to support it. There are various types, depending on:
- Their material. Slings can be synthetic or made of human or animal tissue
- Their shape. Slings can vary in length and width
- The way they attach to tissue
Which type of sling is recommended for you depends on your individual situation and needs. It also depends on the availability of different types of slings in your hospital and your surgeon’s experience with them.
When should I consider a sling?
Sling implantation is the most commonly recommended option for the treatment of SUI. Slings improve SUI in 85 to 90% of cases. If the surgery is successful, the effect is generally long-lasting.
Your doctor can also recommend this surgery if you have mixed urinary incontinence. Because the surgery aims to treat only SUI symptoms, it may be less effective.
How are slings implanted?
For the procedure you usually receive local or spinal anaesthesia, but in some cases you may be recommended general anaesthesia. First the doctor inserts a catheter to make sure that your bladder is completely empty during surgery.
The doctor then makes an incision in the front of the vaginal wall to insert the sling. The two ends of the sling are put in position on both sides of the urethra, shaping the sling like a hammock. Finally, the ends of the sling are attached to tissue. In retropubic slings, the ends are attached just above the pubic bone. In transobturator slings the ends are attached to tissue around the groin (Fig. 1a and 1b).
How do I prepare for the procedure?
Before the surgery the doctor will ask for a urine sample to make sure you do not have a urinary tract infection. If you have an infection, your doctor will prescribe antibiotics before, during, and after the operation.
Your doctor will advise you in detail about how to prepare for the procedure. If you need general anaesthesia, you must not eat, drink, or smoke for 6 hours before the surgery. If you are taking any prescribed medication, discuss it with your doctor. You may need to stop taking it several days before surgery. Your doctor will advise you on when you can start taking it again.
How long will it take me to get back to my daily activities?
The doctor will generally remove the catheter within 24 hours after surgery and monitor your recovery. Usually you can leave the hospital the day after the procedure. If you have problems urinating or there is much post void residual urine in the bladder, you may have to stay longer. The recommended length of hospital stay varies in different countries.
After any surgery, your body needs time to fully recover. It can take up to a month for the wound to completely heal. During this time you may experience pain in the pelvic area, or feel pain when you urinate. You may also have vaginal discharge. Your doctor can prescribe medication to deal with these symptoms.
Recommendations for 4-6 weeks after the surgery:
You need to go to your doctor or go back to the hospital right away if you: