Incontinence Sling

Incontinence Sling

Introduction

The urethra is the tube-like structure that drains urine from the bladder. Like the bladder, the urethral muscles may also weaken, causing you to leak urine during certain activities. Leakage of urine may be noticed when one coughs, laughs, jumps or bends down. Treating this problem involves placing a sling around the urethra to lift it back into its normal position and to exert pressure to aid in urine retention. Usually, asymptomatic women who have this do not need surgery. But for others, surgery may be the only option to help treat the condition and to eliminate the symptoms.

Urethral sling for stress incontinence

Urethral sling surgeries to treat urinary incontinence involve placing a sling around the urethra to provide support and to hold the urethral structure in place. The sling used may be a muscle, ligament, or a synthetic material. It is then attached to the abdominal wall.

Sling Procedures for Women

For women, there are three basic approaches available for sling implantation. In a conventional sling procedure, your surgeon will make an incision in your vagina and secure a sling made of natural or synthetic material around the neck of your bladder. He will then use a small abdominal incision to pull the ends of the sling into place and surgically attach them to your abdominal wall or pelvic tissue. If you undergo this type of procedure, you will probably need a temporary catheter while your bladder recovers. Tension-free slings are synthetic strips of mesh that are implanted without any need for stitches. In this method, your surgeon will place the sling so it is initially supported by your own tissue. Over time, scar tissue that forms as a natural reaction to the mesh will hold it in place permanently. Recovery time from sling surgery may extend from two to six weeks.

Sling Procedures for Men

For men, your sling procedure will typically be done as an outpatient surgery. During the procedure, your surgeon will make an incision in the perineum, or space between your scrotum and anus. He will use this opening to place a sling made from surgical tape around the portion of your bladder called the urethral bulb. This placement allows for a minor adjustment in the position of your urethra, which is frequently sufficient to stop or diminish your incontinence. Consult a surgeon for more information.

Why It Is Done

The urethral sling procedure may be used for women who have stress incontinence: Caused by sagging of the urethra and/or bladder neck. With a history of previous failed surgeries. Complicated by factors such as obesity that creates a risk for failure of other types of surgeries. Caused by problems with the muscular outlet of the bladder (sphincter.

Outcome

Sling surgeries are generally effective in eliminating incontinence. Most patients who have had the surgery have reported lessened or complete elimination of symptoms previously experienced.

Risks

The risks of the urethral sling procedure include the following:

The synthetic sling material may wear away the tissue of the urethra or vagina. The stitches (sutures) used to attach the sling may pull out. This is a higher risk for obese people. Infection may occur at the site of surgical incisions. Rejection of the sling material may occur if the sling was not made from the woman's own tissue. A woman may have problems with sexual function after the surgery.

All surgeries that use general anesthesia carry a small risk of death or complications.

Recovery

To allow healing of the urinary tract, a thin, flexible tube (catheter) is placed into the bladder through the urethra or abdominal wall to allow urine to drain. Expect 2- to 4-week recovery period, during which you should refrain from doing too much work or strenuous activities of any kind. The amount of pain you experience after surgery 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 the abdomen. Your doctor will prescribe medicine to relieve your discomfort during the first few days after surgery. Be sure to call us back if you cannot get relief from pain. Many women have some constipation after this surgery. Make sure you drink enough fluids-between 8 and 10 glasses of water, or no caffeinated beverages each day. Include fruits, vegetables, and fiber in your diet

FAQs

Q:Is urinary incontinence a common condition?

A: Urinary incontinence is a very common condition. In fact, 1 out of every 3 women is affected by one or more types of urinary incontinence. Despite its prevalence however, many women remain silenttoo embarrassed to discuss their condition, even with their doctor. In the United States alone, 13 million women suffer from stress urinary incontinence (a type of urinary incontinence), yet only 16% seek treatment. The low treatment rates are common because women often feel shame and embarrassment about their symptoms, lack information about available treatment options, or mistakenly believe that incontinence is an inevitable part of aging and childbirth.

Where will the doctor get the skin for the reconstructed nipple?

One option is to use the skin of the reconstructed breast, or for the surgeon to take an oval of skin from the outer edge of your mastectomy scar or from the edge of the TRAM donor scar on your abdomen (if you have this kind of Breast Reconstruction), and the last is to get the skin from the inner part of the upper thigh or from behind the ear. The skin is taken from those two locations due to the fact that these skin areas tend to have a darker pigment providing a better contrast to the breast tissue.

Q:How serious is urinary Incontinence?

A: The symtpoms associated with urinary incontinence could dramatically impact your quality of life. In fact, studies show incontinence is linked to depression, anxiety, and stigmatization as a result of the potentially embarrassing symptoms. In severe cases, some women will avoid sexual intimacy, restrict their daily activities (especially when there is a lack of restrooms nearby), wear dark clothing, and resort to managing their symptoms with pads and liners.

Q:Isnt urinary incontinence just a natural part of aging or childbirth?

A: Yes, the stress that pregnancy and childbirth can have on your body may weaken or damage your pelvic floor muscles. Aging as well may contribute to this loss of muscle strength.

Q:When should I seriously think about treating my incontinence surgically?

A: Many patients who undergo this procedure decide to do so mostly because they have tried all other options necessary to try to relieve the symptoms associated with this condition. If the signs and symtoms cannot be managed or controlled, an incontinence sling may be already necessary.

Q:If I dont get treated for urinary incontinence, will it get worse over time?

A: Unfortunately, there is no simple answer to this question. Some women may experience infrequent leaks that dont worsen over time. Some may notice symptoms after childbirth or surgery that improves as their muscle tone improves. Still others will experience urinary incontinence symptoms that progress to a point where they simply cant manage their condition through behavior modification or incontinence products alone. Its important to know that, whether youre just beginning to experience urinary incontinence or youve been coping with it for some time, recording your symptoms can really help you and your doctor accurately monitor your condition. Take note of when you experience symptoms and how severe they are, as well as the special circumstances surrounding each episode.

Q: Can I treat incontinence with medications?

A: If you suffer from urge incontinence (also known as overactive bladder), you may be able to treat your symptoms successfully with daily prescriptions. Unfortunately, there are no medications currently available to treat stress urinary incontinence.

Q:What if I plan to have children in the future? What are my treatment options?

A: If you are pregnant, you are not a candidate for a sling procedure. If you expect to get pregnant in the future, a sling procedure may also not be right for you. The stress placed on your pelvic floor muscles during pregnancy could very well undo the benefits of your procedure. Be sure to discuss this with your doctor and inform her/him of any future plans to have children.

Q: If I treat my urinary incontinence surgically, will it be painful?

A: Some surgical procedures for urinary incontinence are more invasive than others. As a result, recovery from these procedures is generally longer and the associated pain and discomfort is often greater. With newer minimally invasive surgical sling procedures, incisions are smaller and women can expect much less discomfort, as well as a shorter recovery period. As with most surgical procedures, inflammation and irritation can occur. If this happens to you, speak to your doctor. They can prescribe medications to manage your discomfort.

Q:Im considering a sling procedure, but Im concerned about the surgical mesh. Will I be able to feel it inside my body? Could it ever fall out?

A: Since 1965, mesh has been used extensively in surgery and implanted in millions of patients. The soft and porous material allows your bodys tissues to grow into the mesh, anchoring it safely inside your body and providing greater support. Because the mesh is also light, soft, and flexible, you wont feel it after your procedure. While there is a low rate of occurrence, erosion of the mesh could occur. Be sure to ask your doctor which surgical mesh she/he plans to use in your procedure, as well as the specific success and complication rates associated with that mesh.

Q: How long is the typical recovery period for minimally invasive urinary incontinence surgery? Will I be in the hospital?

A: In most cases, urethral sling procedures are performed on an outpatient basis. You can return home within hours of your procedure, and return to normal, non-strenuous activities within a short time. However, you should avoid sexual intercourse, heavy lifting, and vigorous exercise for six to eight weeks following your procedure to allow your body to heal.

Q: What are some complications of minimally invasive surgery?

A: Urethral sling procedures require surgery and are therefore not recommended for everyone. Before you consent to a procedure, you should be fully aware of the risks involved. These include:

Inflammation and irritation Urinary tract infections, urge symptoms, and difficulty with urination In rare cases, infection, erosion, and vessel or urethra perforation may occur