Sling procedure for urinary stress incontinence (synthetic or natural)

What is this?

This operation involves the creation of a supporting hammock by placing a tape under the urethra for support. This will include a cystoscopic examination of the bladder and a small incision in the vagina

What alternatives are there?

Observation, physiotherapy, pads, injection therapy (around the urethra), colposuspension

What to expect before procedure

You will usually be admitted on the same day as your surgery. You will normally receive an appointment for pre-assessment, approximately 14 days before your admission, to assess your general fitness, to screen for the carriage of MRSA and to perform some baseline investigations. After admission, you will be seen by members of the medical team which may include the Consultant, Specialist Registrar, House Officer and your named nurse. You will be given an injection of a blood thinning agent before surgery, and afterwards until you are adequately mobilised. You will be given intravenous antibiotics at the time the anaesthetic is given, and possibly after surgery too. You will be asked not to eat or drink for 6 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. Your surgeon will tell you the type of material (donor tissue, natural or synthetic) they will use, and the type of incision required (vaginal or abdominal)

What happens during the procedure?

Either a full general anaesthetic (where you will be asleep throughout the procedure) or a spinal anaesthetic (where you are awake but unable to feel anything from the waist down) will be used. All methods minimise pain; your anaesthetist will explain the pros and cons of each type of anaesthetic to you.

After the procedure

A catheter will be placed in the bladder for a day or two (sometimes via a small incision in the skin) and there will probably be a wound drain. The average hospital stay is 4 days.

Potential side effects