Vaginal Sling

For some women, symptoms of stress incontinence or overactive bladder don’t respond to conservative treatment. When you’ve tried conservative measures and urinary incontinence continues to disrupt your life, surgery might be an option.

 For a conventional sling procedure, your surgeon uses strips of synthetic mesh, your own tissue, or sometimes animal or donor tissue to create a sling under the urethra or the area of thickened muscle where the bladder connects to the urethra (bladder neck). Through another small incision in your abdomen, the sling would be pulled to achieve the right amount of tension, and then each end would be attached to the pelvic tissue using stiches.

The sling supports the urethra and helps keep it closed so that you don’t leak urine, especially when laughing or sneezing. There are several other different approaches to which sling procedure you could choose, and you and your doctor will decide which option is best for you.

Tension-Free Sling

Retropubic  With a retropubic approach, your surgeon makes a small incision just under your urethra, and two small openings just above your pubic bone large enough for a needle to pass the sling under the urethra and into place behind the pubic bone. Absorbable stiches close the vaginal incision, with glue or more stitches sealing the needle sites.

Tranobturator  In this procedure, your surgeon makes a similar incision as in the retropubic approach, but also creates a small incision on each side of your labia, which a needle will pass through.  The sling will then be placed under the urethra through those incisions.  Absorbable stitches and glue will seal the incision sites.