Urethral Slings: What Are The Risks, Benefits and Recovery?

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Mid-urethral slings have become the most common method to treat stress urinary incontinence (SUI). They are typically placed in under 30 minutes in an outpatient setting and are popular with both physician and patients due to the high cure rate, relative ease of placement, low complication rate and quick recovery.

The prototype of modern day slings is the TVT (tension-free vaginal tape), and many similar ones exist on the market that are placed in a similar fashion, but ultimately perform the same function. TVT has been around for approximately 15 years and is used worldwide.

The sling is made of a thin strip of polypropylene mesh weave, a common and safe type of mesh used for surgery in a variety of body locations. The width is 1 cm and the length left in the body is usually between 6-8 inches long. There are various methods for placing slings, but ultimately, it must rest under the mid-urethra.

It is placed through a small incision in the vagina, usually under general anesthesia, and women can go home the same day without a urinary catheter after urinating in recovery. Vaginal stitches to close the skin dissolve, but the sling is permanent. It becomes incorporated into the body tissue. The body lays new collagen and scar within the sling and around it, and it becomes a new firm ligament under the urethra replacing the one that had become weak. The sling acts like a backboard and supports the urethra during straining maneuvers such as coughing, sneezing, laughing, jumping and exercise. It prevents it from descending, thereby preventing urine loss.

Slings are durable to about 10-15 years but longer term data does not exist simply because it hasn’t been around that long. It is less invasive than the next most popular procedure for SUI, the Burch colposuspension, which requires a bikini line abdominal incision and then the bladder neck is raised up and stitched close to the back part of the pubic bone. Despite equivalent cure rates, surgery time and recovery time is longer. It has generally fallen out of favor as a modern approach to curing SUI.

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EmpowHER Guest

I had my sling put on my bladder over 12 months ago first I couldn't use my bladder for over 6 weeks my specialist gave up and told me that I'd have to self catheterise myself for the rest of my life And I'm only in my early 40's !! and since then I have had nothing but trouble since I get infections all the time and I find If I try and hold my urine it come out its like its back to front the only good thing about its is I don't have any leakage while exercising , coughing or vomiting

September 23, 2015 - 4:38am
EmpowHER Guest

Reading comments, reminds me of my experience with breast cancer: patients were upbeat at first, then the problems start. I just canceled my surgery. Have lived with incontinence for 20 years, just worried because of more frequent UTIs . (Also did not do radiation and chemo for breast cancer - best decision I ever made. Almost five years now cancer free and everyone I know who did all the treatment has been sick ever since. )

August 24, 2015 - 5:12pm
EmpowHER Guest

I am 53 this week, I just had a TVT sling done 5 weeks ago, I am very active. I am do Crossfit and run...I listened to the dr and never did any exercise for 3 weeks, went back to crossfit and lifted lighter for 2 two weeks. Started running and got the go ahead for sex. ALL IS GREAT. I can run, jumping jacks, box jumps, skip and zero leakage. Have had zero complication whatsoever. If in 10-15 years I need it done again, I would not hesitate. The next best thing I ever had done, next to an ablation.

August 13, 2015 - 5:23pm
EmpowHER Guest

I had the mid urethral sling op done jus over two weeks ago. All went fine, I don't even feel like I've had surgery! Does anyone know if it would do any harm if I started exercising again now? I'm itching to run again and get back to the gym!

June 2, 2014 - 3:15pm
EmpowHER Guest
Anonymous (reply to Anonymous)

I appreciate postive comments on surgery as all you can really find is negative! What type of procedure did you have?

September 23, 2014 - 8:27pm
EmpowHER Guest
Anonymous (reply to Anonymous)

I just had this procedure done yesterday along with a posterior repair and instructions are no strenuous activity for at least 6 weeks. I too feel great. If you start running again before the 6 weeks, the pounding impact might alter the healing process. You should relax and wait the 6 weeks.

September 9, 2014 - 5:09pm

I had the urethral sling done Feb 2014 and now it June 2014....and I have been in misery everyday since this was done. The constant urge to urinate is unbearable. Dr. has tried every medicine for overactive bladder. Nothing has worked. Its only getting worse. April he done another urodynamic test he said everything look good, and had me to try another medicine for overactive bladder. That didn't work either. I go back June 14 2014 for him to discuss botox injections in the bladder or interstim placement. I am terrified of trying anything.
The other problems I am having since the sling is terrible pain in my urethrea, burning pain, and my vagina feels as if its stuff full of cotton balls.Also the only way now that I can have a BM is to take laxitives. I used to be a active, happy, outdoors woman, I am not that woman any more. I feel like I'm not living only existing. My whole family is suffering from me having this surgery.

May 31, 2014 - 3:57pm
EmpowHER Guest

Please I need ur opinion because for the past year I been lifting weight, and now the doctor told me the that I'm not suppose to do after he told me that I feel scare please help me I want to continue my exercise I want to be fitness

April 4, 2013 - 9:15pm
EmpowHER Guest

I had this surgery now on day 25 and it's brilliant, my only prob is that sometimes I feel like I have not emptied my bladder enough and I have to concentrate when at the loo to make sure I empty it properly. Thumbs up from me. I hope to go back to spin class tomorrow also so things are on the up!

April 4, 2013 - 2:42pm
EmpowHER Guest

I am 52 not quite 3 weeks postop from a cystocele repair, mid urethral sling. I previously had a total hysterectomy at 30. (Ive had no gyn infections in 20+ years - the only exception, taking antibiotics and what would start out as feeling like a yeast infection would immediately move into my urinary tract). The first week after surgery, I felt a yeast infection. PA "looked" and said no but gave rx. (Fluco?something - 1 pill normally kicks, I took 2). Ive have generally not felt well. As week 2 finishes, I noticed a horrible odor , occasional slight red tinge discharge and then some stringy came off the tp yesterday and last night I see what looks like a tampon string hanging out of my vagina. I am one that does not like to call the dr, even to ask a question. I am getting hounded by family to call as i do not see them for 6 more days. deep down i do fear there is some infection, that something is coming out, but dread more being the paranoid patient.

November 23, 2012 - 7:17am
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We value and respect our HERWriters' experiences, but everyone is different. Many of our writers are speaking from personal experience, and what's worked for them may not work for you. Their articles are not a substitute for medical advice, although we hope you can gain knowledge from their insight.

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