Mid Urethral Sling Surgery for female Stress urinary incontinence

Q 1. What is this procedure?

A. These operations involve inserting a strip of tape made of a synthetic material (polypropylene) to form a sling that supports the urethra (pipe that leads from the bladder to the outside). This helps to stop urine from leaking out.

Mid Urethral Sling Surgery for female Stress urinary incontinence

Q 2. What alternative procedures are available?

A. Other procedures include:

  • Urethral bulking agents (injections)
  • Colposuspension (surgical)
  • Autologous fascial slings (surgical)

Many women who have undergone a period of supervised pelvic floor muscle exercise training will not require surgery.

Absorbent products such as incontinence pants or pad may provide some patients additional ways of treating their urinary problems.

Additionally, devices that are placed into your vagina may occasionally be useful for managing urine leakage, such as during physical exercise.

The alternative to this surgery is to decide not to have surgery and the implications of deciding not to have surgery will be discussed with you.

Q 3. What are the intended benefits of this procedure?

A. The aim of this procedure is to cure or improve stress urinary incontinence. This will not improve symptoms of frequency and urgency.

Q 4. What are the chances of success of this procedure?

A. No operation is guaranteed to cure stress incontinence but these procedures offer a good chance of improving your symptoms. Studies show that 90% of women are cured or have significant improvement after these procedures.

Q 5. What should I expect before the procedure?

A. If you are taking blood thinning medication on a regular basis, you must discuss this with your urologist because these drugs can cause increased bleeding after surgery. There may be a balance of risk where stopping them will reduce the chances of bleeding but this can result in increased clotting, which may also carry a risk to your health. This will, therefore, need careful discussion with regard to risks and benefits. Aspirin does not usually need to be stopped but will be the decision of your surgeon.

You will usually be admitted on the same day as your surgery, or a day before. You will normally undergo pre assessment on the day of your clinic. After admission, you will be seen by members of the medical team which may include the consultant, junior urology doctors and nurse.

You will be asked not to eat or drink for six hours before surgery and, immediately before the operation, you may be given a pre-medication by the anaesthetist which will make you dry-mouthed and pleasantly sleepy.

Please be sure to inform your urologist in advance of your surgery if you have any of the following:

  • Co-morbidities like Diabetes, Hypertension, Coronary artery disease or, stroke, epilepsy
  • Any transmissible disease like HIV/AIDS, Hepatitis B or C etc
  • Presence of implants, pacemakers, graft etc
  • You are taking prescription drugs like-
    • Blood thinners/ anti-platelets i.e. Warfarin, ecosprin, clopidogrel etc
    • Anti-epileptics like phenytoin, valproate etc

Q 6. What happens during the procedure?

A. Before your procedure, you will be given the necessary anaesthetic and/or sedation – see below for details of this and the role of the anaesthetist in your care.

You will be given antibiotics whilst you are asleep; this is administered intravenously (into the vein) by the anaesthetist. This is given as a preventative measure against possible infection. It is therefore important that you tell a member of staff if you are allergic to any antibiotics