Vaginal sling procedures are done to treat stress urinary incontinence. Before discussing surgery, your doctor will have you try bladder retraining, Kegel exercises, medicines, or other options. If you tried these and are still having problems with urine leakage, surgery may be your best option.
If you leak a bit when you laugh, cough, sneeze, jog, or lift something heavy, you may have stress incontinence. This is the most common bladder control problem in younger women. Stress incontinence happens when the muscles and tissues around the opening of the bladder get weak. When there's more pressure against the bladder and this opening doesn't stay closed, leakage happens. Pressure from coughing or laughing may be all it takes for you to leak. They may be stretched by weight gain, a sports injury, or pregnancies and vaginal childbirths.
The gold standard of treatment for stress urinary incontinence is a mid-urethral sling or Tension-Free Vaginal Tape (TVT). The polypropylene sling is placed without tension around the urethra. The sling treats incontinence by providing support under the urethra when abdominal pressure is increased. Success rates of the TVT for patients with no prior incontinence surgery is over 90%. Success rates in patients with prior incontinence surgery may be lower, depending on the individual patient.
You have either general anesthesia or spinal anesthesia before the surgery starts.
- With general anesthesia, you are asleep and feel no pain.
- With spinal anesthesia, you are awake, but from the waist down you are numb and feel no pain.
A catheter (tube) is placed in your bladder to drain urine from your bladder.
The doctor makes one small surgical cut (incision) inside your vagina. Another small cut is made just above the pubic hair line or in the groin. Most of the procedure is done through the cut inside the vagina.
The doctor will use slings made by synthetic material. The sling is passed under your urethra and bladder neck and is attached to the strong tissues in your lower belly. The traditional trans-vaginal mid-urethra sling will create two small incision wound over bilateral inguinal area. For self-pay mid-urethra sling, you won’t have wound over your perinea skin.
Risks and Complications
- More difficulty emptying your bladder, and the need to use a catheter
- Erosion of the synthetic material through your normal tissue
- Damage to the urethra, bladder, or vagina
- Abnormal passage (fistula) between the vagina and the skin
- Irritable bladder, causing the need to urinate more often
- Worsening of urine leakage
The procedure cost is about 170,000~185,000 NTD, prices are subject to change without prior notice, need to pay in accordance with the actual medical expenses.