Tension Free Vaginal Sling

Urinary leak due to stress is the most common type of incontinence in women which causes loss of bladder control. Stress incontinence occurs when your bladder leaks urine when under pressure/ exertion or physical activity. A vaginal sling procedure, also called a pubo-vaginal sling, is a sling is a very effective treatment procedure for the female stress urinary incontinence.

Advantages:

  • Minimal invasive.
  • Minimal hospital stay.

When to approach your Urologist for Tension free vaginal sling?:

  • Leakage of urine happens during:
  • Sneezing/ Coughing.
  • Jogging
  • Exercising.
  • Laughing.
  • Lift Heavy objects.
  • Sexual intercourse.
  • Standing.
  • Any other physical activity.
  • Frequent sudden urges to urinate.

Types:

  • Pelvic floor muscles: The bladder and urethra are supported by the muscles at the pelvic floor muscles. Urine passes from the bladder through urethra.
  • Sphincter muscle: Due to weakening of this muscle around the opening of the bladder that prevents leakage of urine through urethra by sqeezing. Sphincter muscle that is around the opening of the bladder, squeezes to prevent urine from leaking through the urethra.

Diagnosis Tests:

  • Genital Examination.
  • Rectal Examination.
  • Ultrasound.
  • Sanitary pad test.
  • Bladder cytoscopy.
  • Pelvic/ abdominal ultrasound.
  • PVR post void residual.
  • Urinal Analysis.
  • Urinary stress test.
  • Urodynamic analysis.
  • Dye X-rays.
  • Pelvic examination to check if bladder/ urethra slide into the vagina.

Preparation:

  • Avoid blood thinners like ibuprofen/ aspirin by consulting your urologist first.
  • Avoid drinking/ eating 6 to 12 hours before surgery.
  • Dress comfortably.
  • Pre arrange a ride home.

Tension Free Sling Insertion:

  • Sling Insertion: To prevent leakage and to avoid sliding of bladder and instead hold it in a proper position by planting a a piece of a tissue like material.
  • General/ spinal anasthetia is given to the patient pre surgery.
  • Most likely, a tube/ catheter is inserted in the bladder, to drain the urine.
  • The urologist makes a small cut/ incision, in the vagina and another one incision around the pubic hair line.
  • The urologist will then, insert a strip of synthetic material/ tissue ie the sling through the incision to secure it around your urethra.
  • This is a permanent tension free mesh like material, placed underneath the urethra.
  • This is fixed above the pubic bone, to the muscles of the abdomen.
  • This tension free vaginal sling remains permanently as an urethral sling and thus prevents female urinary stress leak.

Risks:

  • Prolapsed/ dropped vagina.
  • Fistula growth.
  • Irritable bladder.
  • Over-reactive bladder.
  • Vaginal/ urethra/ bladder injury.
  • Problematic incomplete urination.
  • Complications due to sling break down over time.

Post- Surgery:

  • Use of panty liners, plastic- coated under garments, adult diapers.
  • Plastic mattress under the bed sheet for night protection.
  • Regular follow up with your urologist.

All above, treatments are finalized taking into consideration the overall health, severity, age and other ailments of the patient.