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The mid urethral sling is the most common procedure used to treat urinary stress incontinence in women. Stress incontinence results in the loss of urine with activity such as walking, coughing or sneezing. Urinary stress incontinence is more common in women than men.
Stress incontinence is due to a lack of tissue support of the bladder and the urethra. This occurs most commonly as a result of pregnancy with vaginal delivery, diabetes, obesity, or aging.
While lifestyle changes such as weight loss and Kegel exercises may help with mild cases, sling surgery is the best option for more severe cases.
The first step towards being approved for a urinary sling procedure is to schedule a consultation appointment with Dr. Lazare. During this appointment, you will discuss your medical history, any current medications that you are taking, and any allergies that you may have.
Dr. Lazare will talk to you and he will obtain your medical history. He will then carefully examine you and he will test your urine. Most patients who are candidates for the procedure will undergo two additional tests – cystoscopy and urodynamics. These tests are both performed in the office.
Cystoscopy involves the insertion of a small fiber-optic telescope into the bladder. This enables Dr. Lazare to inspect the inside of the bladder and to make sure that there are no other issues.
Urodynamics involves placing a small soft catheter into the bladder and filling it with water. The pressures are measured during bladder filling and during urination. This test determines if your bladder is in good working order.
If you are a good candidate, your mid-urethral sling procedure will be performed at the hospital on an outpatient basis. You most likely will return home immediately after your procedure. You will receive general anesthesia from a board-certified anesthesiologist. The operation usually lasts less than 90 minutes.
To perform this procedure, Dr. Lazare makes a small incision in the vagina just below the urethra. He then places a small artificial mesh under the urethra which provides support. The mesh is placed under slight tension. After mesh insertion, Dr. Lazare always inspects the inside of the bladder with a cystoscope to ensure that the mesh is in the correct position. The small incision is then closed with absorbable suture that dissolves on its own.
The most common risk is difficulty emptying the bladder following the procedure. This is usually easily managed with a temporary catheter. Prolonged urinary retention is uncommon. Removal of the mesh due to prolonged urinary retention is rarely necessary.
You should understand that the mid – urethral sling does involve the insertion of mesh. Mesh insertion for slings has generally not been a problem. Mesh infection and erosion, however, is possible in a small percentage of cases. If this occurs, the mesh must be removed.
The long-term success rate of the sling using mesh is about 80%. The success rates of anti – incontinence procedures are higher when mesh is used. The risks of these procedures that involve mesh, however, are slightly higher as compared to procedures that do not involve mesh.
After the urinary sling procedure, you may experience discomfort for a few days or weeks. Most women see results right after the procedure. Straining, exercising, and lifting heavy objects should be avoided until Dr. Lazare says it’s OK. Be sure to follow Dr. Lazare’s specific post-op instructions for the best possible recovery.
If you are interested in learning more about your treatment options for stress urinary incontinence, contact our office today. Our board-certified urologist, Dr. Lazare, has the surgical skill and eye for detail to create the effective results you deserve.