Advanced Gynaecological Surgery Centre
 
Treatment Options

Suburethral Sling for Incontinence

What is a Suburethral Sling?

  • A suburethral sling is a minimally invasive vaginal operation to help treat certain types of urinary incontinence.
  • The sling is polypropylene mesh (type of plastic) and acts as a new ligament to strengthen the support structures of the bladder, which may have become weakened or damaged by pregnancy, childbirth, age or hormonal changes.
  •  This lack of support can result in women leaking urine when they cough, sneeze or exercise.

How does the Suburethral sling work?

  • This tape is approximately 1cm wide and acts as a scaffold so that your tissue can grow into it.
  • It is inserted through a small incision underneath the urethra (the tube that runs from the bladder   outwards) so that when you cough and sneeze the tape is able to close off that tube.
  •  There are different variations - the tape can either come just behind the pubic bone, slightly above the hairline on the abdomen or in the groin.
  • The procedure takes approximately 15 minutes and involves small puncture incisions either in the groin or just above the hairline. More recently exit less tapes have been developed.
  •  The tape is not stitched in as it fixes itself within your tissues but the incision is closed in the vagina.
  • A cystoscopy is performed to make sure that the tape has not accidentally entered the bladder.
  •  Antibiotics are given to prevent infection of this mesh.

What is the success rate?

  • Current evidence would suggest that depending on the nature of your incontinence you may expect up to an 85% chance of either curing or improving your symptoms significantly for at least three years.

Complications

  • Major complications seem to be rare for this procedure.
  • Injury to the bowel or a major blood vessel occurs in less than 1 in 1,000 procedures.
  • Not being able to pass urine normally occurs in approximately 5% of cases. This usually resolves in the first few days. The bladder may need to be drained with a catheter during this time.
  • A small percentage of cases, less than 1%, will continue to have difficulty passing urine. 
  • This usually resolves within 2-3 weeks. If it continues the tape may need to be divided.  This does not necessarily mean that the operation will not work.                   
  • Occasionally the mesh may work its way through the vaginal tissues which is called a mesh protrusion, which although not serious can be a nuisance. This can resolve by itself, but may need to be repaired in theatre.
  • Erosion of the mesh into other organs occurs very rarely.
  • Pain, pelvic, groin, vagina pr with sex can occur and although usually settles can persist and be hard to treat.
  • In rare cases further surgery to remove the mesh may be required.
  • Other complications include infection of the mesh and bruising following the operation.

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