Benefits of the Female Incontinence Sling

Females suffering from stress incontinence sometimes assume that urine leakage is just a part of life. Many women do not seek medical assistance assuming that there is nothing to be done. However, incontinence sling procedures are highly effective in reducing the incidence of urinary leakage upon coughing, sneezing or straining.

The concept behind the sling procedures is elegantly simple. Pressure is applied to the tube, which transports urine out of the bladder (the urethra) and the neck of the urinary bladder to close it and prevent unintended escape of urine. The surgeon places a sling through an incision, either in the abdominal wall (percutaneous transabdominal approach), or in the wall of the vagina (transvaginal).
There is a wide variety of materials used to manufacture the sling. The sling may be made from synthetic mesh, the patient’s own abdominal fascia, which is the tendon-like fibrous material sheathing the abdominal muscles, or human cadaveric donated tissue. Human tissue is usually preferable because it does not illicit a strong inflammatory reaction, which may cause excessive fibrous tissues formation around the incontinence sling leading to pain, an increased risk of infection and a higher rate of complications.

The transvaginal approach is a minimally invasive procedure which involves a small incision in the vaginal wall giving access to the neck of the bladder, or the junction between the urethra and the bladder. The surgeon places two small anchors at the backside of the pubic bone. These anchors are part of the Precision Track Transvaginal Anchor System commonly used for incontinence sling operations. The tiny anchors are placed one at each side of the pubic bone, symmetrically, to create a base for fixating the bladder neck. After the surgeon ensures that the tracks are in place, a sling is inserted, passed around the bladder neck and base of the urethra like a hammock and attached to the pubic bone tracks with sutures. The procedure is also known as a pubovaginal incontinence sling operation. The transvaginal approach allows for a surgery free from abdominal scars and generally has excellent results.

The percutaneous approach uses two incisions. The first is an incision in the abdominal wall, usually in the crease just above the pubic bone. The surgeon fashions a strip of the patient’s own abdominal facia into a sling. The second incision is made in the wall of the vagina to expose the bladder and urethra. The surgeon then grasps the fascial sling and adjusts the tension around the bladder neck until the urethra is properly supported.

The presence of vaginal scars carries the inconvenience of a prolonged recovery period in which sexually activity is restricted. Sexually active women are warned that they may have to abstain from sex for a period up to eight to twelve weeks, depending on the size of the vaginal incision, to allow for complete healing.

Finally, it is worth noting that incontinence sling procedures are habitually reserved for severe cases of stress incontinence, which have not responded to pelvic floor strengthening measures and interventional therapies.

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