Sling Treatment for Stress Incontinence
Sling procedures at a glance
- Sling procedures are the most common treatment for stress incontinence.
- Doctors can utilize a sling, made of tissue from your own body or synthetic mesh, to support the bladder and urethra to stop leaking urine during activity.
- There are several types of sling procedures, and all have high success rates coupled with a low risk of side effects or complications.
How slings prevent stress incontinence
Stress incontinence occurs when the physical act of coughing, sneezing, laughing or exercise causes the urethra to descended under the pelvic floor, causing the involuntary release of urine.
Sling procedures use tissue from your own body or synthetic mesh to create a “sling” or “hammock” to provide support to the urethra, helping to keep the urethra closed and prevent leakage of urine.
The sling can also be made from donor tissue or animal tissue. However, most sling procedures rely on synthetic material or tissue from the patient due to the human body’s predisposition to absorb donor and animal material.
The average rest period following surgery differs from patient to patient and by type of procedure. However, most patients are back to normal activity within two to eight weeks. The biggest restriction after surgery is a five-pound weight restriction. If you think of a gallon of milk being eight pounds this is your weight restriction.
What causes stress incontinence?
The most common cause of stress incontinence is brought on by childbirth, and one third of all postpartum women develop symptoms. However, males can also experience stress incontinence. Urinary incontinence is a common condition, with an estimated 25 million Americans showing symptoms.
Common causes of stress incontinence that can be treated by a sling include:
- Mothers of multiple children and women who gave birth vaginally are at greater risk for stress incontinence than mothers with only one child or when delivered through surgical means.
- Women highly active in athletic activities requiring long distance running or extended period of small, sharp impacts (such as running on hard surfaces, jumping repeatedly on a hard surface or heavy weight lifting) may develop stress incontinence.
- Menopause or estrogen deficiencies increase the risk of stress incontinence in women due to thinning of the urethra and weakening of the pelvic floor.
- Injury caused by radiation in cancer treatment can also increase the risk of stress incontinence.
Types of sling procedures for stress incontinence
The type of sling procedure best for you can only be assessed by a qualified urogynecologist after careful examination of a patient’s medical history. Some types of sling treatment are better suited for patients than others due to prior existing medical conditions, previous surgical history or severity of incontinence.
Kinds of sling procedures to treat stress incontinence include:
Tension free slings
Tension free slings require no stitches and rely on the body’s own ability to heal to hold the sling in place and support the urethra. There are two different methods of creating the tension free sling within the pelvis.
The first method is a retropubic sling, in which a minimal incision is made underneath the urethra, while two smaller incisions are made above the pubic bone for anchoring. The surgeon inserts the sling using a very small needle. The sling itself will not require stitches or further anchoring, as the woman’s body will form scar tissue over time to hold the sling in place. The incision sites are closed with sutures, dissolvable stitches or skin glue.
Autologous fascial sling
After a vaginal incision is made by the surgeon, the sling is made from fascia which is connective tissue in the abdomen. The sling is inserted and brought around the bladder. The ends of the sling are then stretched to meet an abdominal incision. Once the proper sling tension has been achieved, the surgeon attaches the sling to attaches the abdominal wall itself, using stitches.
It should be noted that conventional slings are a more invasive surgical processes than tension free slings, meaning in some cases larger incisions are required, resulting in a longer hospital stay and slightly longer recovery time.