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

By Matthew Karlovsky M.D.
 
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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.

Add a Comment43 Comments

EmpowHER Guest
Anonymous

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)

Hello,
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.
Sylvia

September 9, 2014 - 5:09pm
miseryaftersling

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.
The conclusion of my story :TO ALL WOMEN NEVER HAVE A SLING OF ANY KIND PLACED IN YOUR BODY

May 31, 2014 - 3:57pm
EmpowHER Guest
Anonymous

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
Anonymous

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
Anonymous

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
EmpowHER Guest
Anonymous

I had the surgery about six months ago. No problems but now it seems like I constantly have UTI 's. Prior to the surgery, I did have UTI's but they were treated with antibiotics. Now nothing helps. The most symptom I have is my urine has a strong odor. The doctor said there is nothing they can do....it must be from the sling. I had a ultrasound done. The doctor said to drink lots of water (which i do) and possibly start taking cranberry pills. Any suggestions what the constant UTI symptoms could be from and also, what can I do to fix it?

October 19, 2012 - 12:13am
Stacey F.

I am very active and was looking forward to my sling surgery so I could get back to running and exercising without wearing big pads. My surgery was on June 18 by a well-respected UroGynecologist in Boston. Now, 1 month later, I have worse problems then before. I leak continually and when I tried to run for the first time today I soaked my pad. I am beyond disappointed and discouraged because I took 1 month off from work and have not been able to enjoy Summer with my children because I couldn't be active while I healed. It was very frustrating not being able to exercise when that is such an important part of my life (it's actually my career.) I have called the doctor's office and they tell me to wait, but so far, not impressed. I would urge anyone considering this to be aware that it may NOT be the magic bullet. I was hoping to not wear pads anymore but obviously I will need to invest in them even more now.

July 19, 2012 - 6:38am
EmpowHER Guest
Anonymous

I had the original surgery in May 2010 My first CORRECTIVE surgery was in December 2011 with the 2nd one scheduled in 2 weeks. Never was I told about the FDA warning. No woman should consider this surgery. There are alternatives. The mesh was rushed through the FDA approval process orginially, I wish the FDA would rush the recall. Complaints are coming in exponential numbers. Recall is only a matter of time.

April 2, 2012 - 11:04am
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