Sling vs. Mesh: What You Need to Know

Slings and mesh are very similar but there are a few key differences that will help you distinguish what is what


Vaginal Sling vs. Mesh Are you confused about the difference between vaginal slings, transvaginal mesh and other types of mesh? If you wonder whether or not these methods of providing support for pelvic organs are safe and if they might be right for you, you’re not alone.

Slings and mesh are very similar—surgically placed material designed to treat incontinence or prolapse conditions. But there are a few key differences that will help you distinguish what is what, what is safe and what may be a treatment possibility for you.

Slings: The gold standard for treating incontinence

Slings are the most common way to treat stress incontinence for women. The sling acts as a hammock to support the urethra and prevent it from opening during such physical stimulation as a laugh, sneeze or cough. To place a sling, a urogynecologist accesses the urethra through the vagina to position the sling directly under the urethra.

The sling itself may be made of synthetic mesh or a woman’s own tissue (usually from the abdomen). Here at CU, we typically use synthetic material over human tissue because we have found it to cause fewer side effects for patients. Each case will be different and depend on a patient’s unique circumstance.

The types of slings available are pubovaginal or suburethral. Pubovaginal sling procedures involve a minimally invasive surgery that includes a small vaginal incision through which the sling is placed under the urethra to support the organ during movements like sneezes and coughs. This is a highly successful procedure and over 90 percent of patients experience resolved incontinence issues.

A suburethral sling sits around the urethra and is actually attached to the abdominal wall. It’s a more invasive procedure than placing a pubovaginal sling and requires a couple of days in the hospital following the surgery.

To fear or not to fear mesh

If you’ve Googled vaginal mesh in the last 15 years, you’ll no doubt have read about the complications and subsequent lawsuits surrounding transvaginal mesh. Developed in the ’90s, transvaginal mesh treats pelvic organ prolapse as well as stress incontinence.

The most common material for transvaginal mesh is polyester or polypropylene. One of several problems surrounding transvaginal mesh was a lack of available training for Ob/Gyns to learn how to place the mesh safely.

In 2011, the U.S. Food and Drug Administration issued a formal statement that the use of transvaginal mesh may put women at a higher risk of complications without increased benefit to their quality of life. This is what has sparked a large debate about the issue and a number of television commercials seeking patients to file lawsuits against their surgeons.

At CU, we are not currently recommending or performing any transvaginal mesh applications. We do, however, perform transvaginal mesh removal and repair.

So remember, just because you hear the word “mesh” doesn’t mean it’s the transvaginal type and harmful to your body.

In fact, CU Urogynecology often recommends mesh as part of a sling treatment, for both incontinence and prolapse conditions.

The most important point is that seeking treatment from a board-certified urogynecologist will provide the most specific and best care possible for your incontinence and prolapse conditions.

University of Colorado Urogynecology is a specialty women’s health practice focused on female pelvic health and surgery. Our physicians are also professors & researchers for the CU School of Medicine, one of the top-ranked medical schools in the nation.

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