A bladder sling procedure, also referred to as a mid-urethral sling surgery is one of the most popular procedures in the surgical treatment of incontinence.
How are Bladder Sling Procedures carried out?
The two most common types of bladder slings are the TOT sling, a trans obturator tape sling and the TVT sling, a tension-free vaginal tape sling. Slings are often created from muscle, ligament or tendon tissue taken from the woman or an animal. It may also be composed of synthetic material such as plastic that is compatible with body tissues or of an absorbable polymer. During a bladder sling procedure, a sling is placed around the urethra to lift it back into a normal position and exert pressure on the urethra to aid urine retention. The sling is then attached to the abdominal wall. A bladder procedure helps close your urethra and bladder neck, a part of the bladder that connects to the urethra. The urethra is the tube that carries urine from the bladder to the outside.
When should a Bladder Sling Procedure be recommended?
Bladder slings are ideal for people who suffer from stress incontinence, which is the involuntary loss of urine when putting pressure on the bladder during activities such as coughing or physical exercise.
Stress incontinence is often caused by:
> Sagging of the urethra and/or bladder neck.
> A history of previous failed surgeries.
> Complications by factors such as obesity that create a risk for failure of other types of surgeries.
> Problems with the muscular outlet of the bladder (sphincter).
Before discussing surgery options, your doctor will first recommend that you try bladder retraining, Kegel exercises, medicines or other methods. If you are still having problems with incontinence after trying these treatment methods, a bladder sling procedure may be the best option for you.
What can you expect after having a Bladder Sling Procedure?
Bladder sling surgeries involve incisions, which means that hospitalization is required. To allow the urinary tract to heal, a thin, flexible catheter is placed into the bladder through the urethra or belly wall to allow urine to drain.
You are likely to go home 2 to 3 days after the surgery if there have been no complications. After you are at home, you can expect a 2 to 4 week recovery period, during which you should refrain from doing too much work or strenuous activities of any kind.
What are the potential risks of Sling Procedures?
It is estimated that 8 out of 10 women are cured after bladder sling procedures, making the surgery an effective solution for treating stress incontinence.
However, conventional continence procedures have well-documented possible complications. Immediate complications of sling procedures can include haemorrhage, urinary tract, visceral injuries and urinary tract infections. Short-term problems include wound infection, osteitis pubis, nerve injuries and voiding dysfunction. Long-term complications include bladder overactivity, stitch/ sling erosion, dyspareunia and genital prolapse.
Some people find they experience a small amount of pain after having surgery. The likelihood of experiencing pain however depends on the exact nature of your procedure, your physical condition at the time of surgery and your own response to pain. You will probably feel some pain at the incision site and may feel some cramping in your abdomen. Your doctor will prescribe medicine to relieve your discomfort during the first few days after surgery. Be sure to call your doctor if you cannot get relief from pain.
It is common to experience constipation after this surgery. Once you have had the surgery, there are some things you can try to avoid constipation. The following tips can help you to reduce symptoms of constipation:
- Ensure you eat foods that are high in fibre such as vegetables, beans and whole grains in your diet each day.
- Drink plenty of fluids, enough so that your urine is light yellow or clear like water.
- Take a fibre supplement such as Citrucel or Metamucil every day if needed.
- Schedule time each day for a bowel movement. Having a daily routine may help.
You should inform your doctor if you still have constipation after you have tried these methods.
Read our blog about stress incontinence and how it can be treated for more guidance.