Urethral sling surgeries to treat
urinary incontinence involve placing a sling around
urethra to lift it back into a normal position and to
exert pressure on the urethra to aid urine retention. The sling is attached to
the abdominal (belly) wall.
The sling material may be muscle, ligament, or
tendon tissue taken from the woman or from an animal, such as a pig. It may
also be composed of synthetic material such as plastic that is compatible with
body tissues or of absorbable polymer that disintegrates over time.
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These surgeries involve deep
incisions, so hospitalization is required. To allow the urinary tract to heal,
a thin, flexible tube (catheter) is placed into the bladder
through the urethra or belly wall to allow urine to drain.
will likely go home 2 to 3 days after the surgery if there have been no
complications. After you are at home, expect a 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 have 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 your abdomen. Your
doctor will prescribe medicine to relieve your discomfort during the first few
days after surgery. Be sure to call your doctor if you cannot get relief from
Many women have some constipation after this surgery. You can try some things to avoid constipation:
Include fruits, vegetables, beans, and whole grains in your diet each day. These foods are high in fiber.
Drink plenty of fluids, enough so that your urine is light yellow or clear like water.
Take a fiber supplement, such as Citrucel or Metamucil, every day if needed. Start with a small dose and very slowly increase the dose over a month or more.
Schedule time each day for a bowel movement. Having a daily routine may help. Take your time and do not strain when having a bowel movement.
Tell your doctor if you still have constipation after you have tried these methods.
The urethral sling procedure is
more complicated than the other surgical methods for correcting stress
incontinence and involves a greater risk of damage to the urethra. It is
sometimes done after other surgery for stress incontinence has failed.
Using a woman's own tissue
for sling material eliminates problems with rejection of the sling. It also reduces
the risk of the wearing away (erosion) of the urethra or vagina. But using a woman's own tissue increases surgery time and increases the number of incisions required. This is because
the sling tissue must be taken from the woman's body.
having surgery for urinary incontinence, ask your doctor about the
How much success has the doctor had in treating incontinence with surgery? The success of surgical
procedures for urinary incontinence depends on the experience and skill of the
Is there anything I can do to increase the likelihood of a successful surgery? Losing weight, quitting smoking,
or doing pelvic floor (Kegel) exercises prior to surgery may increase the
likelihood of regaining continence after surgery.
American Urological Association (2009). Guideline for the surgical management of female stress urinary incontinence: Update (2009). Available online: http://www.auanet.org/content/guidelines-and-quality-care/clinical-guidelines.cfm.
Primary Medical Reviewer
E. Gregory Thompson, MD - Internal Medicine
Specialist Medical Reviewer
Avery L. Seifert, MD - Urology
September 11, 2012
WebMD Medical Reference from Healthwise
September 11, 2012
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