Introduction to the Sling for Urinary Incontinence

The bladder sling is the most common surgical treatment for stress urinary incontinence. In fact, slings have been used to treat incontinence for over 100 years! Here’s an introduction to urethral slings.

What is a Bladder Sling?bladder sling

A bladder sling, or suburethral sling, is a general term for a surgical procedure when a strip of material is placed under the urethra to provide support and treat stress urinary incontinence.

What a sling is not.

There are many terms that have been used to describe procedures to help with incontinence. In some cases, these terms can be confusing and inappropriate. One common example is “bladder tack”. Although incontinence is commonly thought to arise from bladder problems, a sling procedure does not “tack” up the bladder. In contrast, a sling is placed under the urethra (the urinary channel that empties the bladder). And there are procedures that do provide support underneath the bladder to help treat another condition called pelvic prolapse, making this term even more confusing.

What does a sling treat?

A sling is used for a specific type of incontinence (leakage of urine) called stress urinary incontinence (SUI). This is incontinence that occurs in the setting of activity, such as coughing, sneezing, laughing, exercising, and lifting.

What a sling does not treat.

There are many other types of urinary incontinence that result from other problems with the urinary tract. One common type is urge urinary incontinence (UUI), which is loss of urine associated with a sudden sense of urgency. Many people with this problem say, “I can’t make it to the bathroom in time”. UUI is commonly associated with other symptoms, which include urgency (rushing to the bathroom), frequency of urination, and getting up at night. Urethral slings do not treat UUI and these other symptoms. Check out additional hfitness blogs to learn more about treatments for these problems.

What is a sling made of?

The term sling is broad and can be composed of many different types of materials. The first slings were made of patient’s own tissues and these slings are still commonly used today. Examples of these tissues include fascia (strong bands of connective tissue) taken from the leg or belly regions. More recently, mesh (a surgical net-like plastic) has been used.

Which sling is best?

There are many different companies that produce synthetic slings. With minor exceptions, these slings are all generally similar. They are all made of the same material and are placed in a similar fashion. Each company gives their sling a different name, much like automobile manufacturers give their cars different names. Despite all these different names, slings all provide urethral support. And, in general, studies have not shown that one sling is more effective than another. As a result, the choice of sling generally has to do with which sling your surgeon prefers.

I have heard that mesh is dangerous?

Mesh sling have been proven to be a very effective treatment of SUI. Like any surgical procedure, there are also risks. And, in the case of mesh slings, some of these risks are related to the use of mesh. A physician can provide detailed counseling regarding these risks and benefits. And, your physician can also educate you on the risks and benefits of slings using your own tissue so you can make an educated decision on which sling is best for you. Check out additional hfitness blogs to learn more about mesh.

What does a sling procedure entail?

In general, slings are a quick out-patient procedure performed under anesthesia. Most patients report minimal pain, although discomfort to the legs or groin for a couple days is not uncommon. To allow for proper healing and support of the sling, strenuous physical activity must be avoided for several weeks afterwards.

How long does a sling last?

The honest answer is we don’t know. The way we understand how long surgeries last is through medical studies. Mesh slings have only been available for a little over 20 years. And, it is rare to find studies that comprehensively follow patients for many years, let alone decades. We know that slings provide improvement of incontinence in most patients and this tends to last for years. But we don’t have enough research to be able to know whether these effects will last for decades.

Should I consider a sling?

Consultation with a specialist is important to help you learn more about treatments for SUI. In general, natural and non-invasive treatment options provide the best initial therapy (such as hfitness!). Often, these therapies can be effective and help avoid surgery. If these approaches are not successful, a sling can be considered to help fix your incontinence. Most importantly, while incontinence is highly bothersome, it is not generally dangerous. For this reason, treatment is individualized to each patient and how much they are bothered by their incontinence.