The purpose of the vaginal sling procedure is to create a
hammock of support and to help prevent the urethra from opening
when you cough, sneeze, or laugh. The procedure involves placing a
piece of material under the urethra. The material options available
to us include synthetic mesh (polypropylene mesh), your own
tissues, or other selective tissue sources. The procedure can be
performed in one of two ways: just above the vagina on the lower
abdomen (retropubic) or into the groin creases (transobturator
technique).
Many patients also have a cystocele (dropped bladder), rectocele
(herniated rectum into the vagina), uterine, or small bowel
(enterocele) prolapse. If so, we may need to broaden the scope of
your surgery and may use mesh to help in the repair. Your own
tissues will typically become incorporated into the mesh in a few
months. If your own tissues appear too weak, we may recommend the
use of other tissues or materials to help our repair. The materials
we use include cadaveric tissue, porcine tissue or synthetic
materials to provide additional support to the bladder and
urethra.
 An incision is made to the vaginal wall and a
mesh-like strap of material is positioned underneath the urethra.
This creates a supportive sling or hammock that helps to reduce or
eliminate urinary incontinence. |
What does the surgery entail?
Vaginal sling procedures are usually performed on an outpatient
basis, however, in some cases, we may keep you for 23 hours in the
hospital or in an ambulatory surgical center. The procedures are
done almost entirely through the vagina. A small incision is
necessary just above the hairline or in the thigh creases for
placement of some sutures or the mesh. Since this is only a small
incision with minimal dissection, there is less discomfort and more
rapid healing. You will have absorbable sutures in the vagina that
dissolve in several weeks time. The retropubic sling approach
requires permanent sutures just above the hairline that may on
occasion be felt as a lump, but this subsides with time.
What are the risks and complications of the vaginal sling
procedure?
Complications of this type of procedure are rare but may occur.
The most common complications include bleeding and infection,
erosion or infection of the graft material (possibly requiring
further surgery), injury to nearby structures, pain, inability to
urinate (retention of urine), recurrent or worsening incontinence,
new or worse vaginal prolapse, urgency or urge
type-incontinence.