Incontinence Sling

The “Slings” you hear about are for Stress Incontinence (leakage of urine that occur with laughing, coughing, sneezing, jumping, trampolines. Slings are made of polypropylene, an inert nylon, that is placed right under the mid urethra to act as a backboard when pressure from above (cough/sneeze/laugh/jump) compresses the urethral tube into the sling to prevent leakage. Slings are “Tension-Free” because the slings are free floating and not sutured into any structure. This is the current Gold Standard of incontinence surgery.

You may hear the term “TVT” or “TOT” which refers to the route the slings are placed. TVT, or tension-free vaginal tape is placed through incisions right above your pubic bone. TOT (transobturator tape) is placed through incisions on the crease of your inner thighs. Once healed you can barely see these incisions. Both procedures are outpatient surgeries of about 15 to 30minutes and can be done with pelvic floor repair and cosmetic procedures such as labiaplasty and vaginoplasty. The success rates vary from 80 to 95 percent. Occasional complications of mesh eroding through skin, urethra, or bladder do occur. Other complications are slings that are too tight preventing urination. I use a sling system I helped design back in 2002 which has proven to be safe, works well, and is enduring. They are shown in the example surgery below with my hands holding them.

Mature woman with incontinence

Surgery Example

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The polypropylene (Nylon) sling in its plastic sleeve getting ready for implant.

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The sling in place and getting adjusted for just the right tension.

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Suturing the incision closed

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All done with the closure for the sling and ready to fix the bladder falling down. The blue mesh coming out of the groin is part of the sling and will be trimmed off. Slings and bladder repairs often go together.