Sling surgery treats stress urinary incontinence, the leakage that happens when coughing, sneezing or during exertion, by placing a supportive tape under the urethra. It is not suitable for every type of incontinence; the decision is made after a urological assessment.
In some women, urine leaks when they cough, sneeze, laugh, run or lift something heavy. When this significantly affects daily life, surgical treatments commonly known as sling surgery may be considered for suitable patients.
Who Is Sling Surgery For?
The first step is to find out why the leakage happens. Leaking before you can reach the toilet and leaking when you cough are not the same problem, and they are treated differently.
Sling operations are used for stress urinary incontinence, the leakage that occurs when pressure inside the abdomen rises. Whether the operation is right for you is decided by looking at your symptoms, the examination findings, the treatments you have already tried and, if needed, the results of further tests, all together.
How Is the Operation Performed?
The aim is to support the urethra and so reduce leakage during exertion. To do this, a thin tape that acts as a support is placed under the urethra.
TOT and TVT, which you may hear about at your consultation, are two different approaches to this operation. Both have the same goal; what differs is the path the tape takes through the body. The choice is not made simply on the name of the method; your previous operations, examination results and general health are all taken into account. The difference between the two methods is explained separately on the TOT and TVT page.
After the Operation
The first thing checked is whether the bladder is emptying properly. Some patients may need a catheter for a short time. Once a normal pattern of passing urine is established, a follow-up plan is made.
In the first few days there may be mild pain, tenderness or an unusual sensation when passing urine. Recovery time varies from person to person, so it would not be right to give everyone the same date. You will need to avoid heavy lifting and strenuous sport for as long as your doctor advises, and you should not miss your follow-up appointments.
If you cannot pass urine, or you have increasing pain, a fever, unexpected bleeding or any other symptom that worries you, contact your doctor without delay.
Will the Incontinence Go Away Completely?
The aim of the operation is to stop the leakage or reduce it significantly. However, no operation can guarantee the same result for every patient. The outcome is affected by the type and severity of the incontinence, age, weight, other health conditions and previous treatments.
After surgery some patients develop new frequent urination, sudden urgency or incomplete bladder emptying. Less commonly, the tape wearing through into the vaginal tissue (erosion), long-lasting pain in the groin or pelvis, and pain during sex have been reported. For this reason, the possible risks are discussed with you in as much detail as the expected benefits before surgery.
Is It Suitable for Every Woman?
No. Just as there is more than one type of urinary incontinence, there is more than one treatment. For some women, lifestyle changes and pelvic floor exercises come first; for others, surgical options are considered. The question "I leak urine, should I have sling surgery?" can only be answered after an examination.
