Vaginal Sling Procedure Overview
A vaginal sling procedure, also called a pubovaginal sling,
is a type of surgery that helps women who have urinary incontinence.
Urinary incontinence is the medical term for an inability to
control the bladder—a problem that leads to urine leakage. For some people, the
leakage occurs after coughing or sneezing. Others with this condition may have
strong, sudden urges and leakage before they can make it to the toilet. When
this problem becomes so severe that it affects daily life, your doctor may
recommend a vaginal sling procedure to correct or help with this problem.
When you urinate, a circular-shaped muscle around your
bladder relaxes and releases urine into a tube called the urethra. During a vaginal sling procedure, the doctor
will use a piece of tissue (either synthetic or from your body) to make a sling
around the urethra to help keep it closed.
What Is the Purpose of a Vaginal Sling Procedure?
Urinary incontinence can be corrected with a variety of
treatments, depending on how severe the condition is. If you have leakage that
doesn’t stop even after trying other treatments, your doctor may recommend
surgery, or the vaginal sling procedure. Your doctor may also recommend this
procedure if you have a very severe case and your bladder problem disrupts your
Types of Vaginal Sling Procedures
There are three main types of vaginal sling procedures:
Conventional slings are created by using a synthetic
material, your tissue, animal tissue, or tissue from a deceased person’s body.
This tissue or material is then inserted around the urethra and fastened with
Tension-Free Slings (or Tension-Free Vaginal Tape)
During this procedure, the physician places a material,
usually made of mesh, around the urethra like a sling. Instead of using
stitches to keep it in place, the tension-free sling is held in place by the
This is a kind of sling that can be adjusted during and
after surgery. One benefit of this is that it can be done while you are awake.
This particular procedure is currently being studied by researchers. It is not
known how effective it is compared to the other sling types.
Are There Any Risks?
Any time you undergo surgery or have an opening made in the
skin, there are basic risks involved. These risks include bleeding, blood
clots, breathing problems, and infection.
There are also some specific risks if you have a vaginal
sling procedure, including:
- changes in the vagina (dropping or prolapsed
- fistulas (an abnormal growth or tunnel that
forms between the skin and the vagina)
- injury to structures around the area (bladder,
- irritation around the bladder
- overactive bladder or problems emptying the
Over time, the material used to create the sling can break
down and create complications. If you are elderly and have atrophic vaginitis,
this surgery may not be recommended.
How Do You Prepare for This Test?
Before the procedure, be sure to tell the surgeon about any
medications you are taking, especially if you are on a blood thinner. Your
surgeon may have you stop taking it a few days or hours before the surgery. You
may also need to stop taking other medications that thin the blood, such as
aspirin and ibuprofen.
Because surgery often involves anesthesia, you will probably
have to abstain from eating or drinking anything for six to 12 hours before the
Be sure to dress in comfortable clothes and arrange a ride
What Happens During This Procedure?
A vaginal sling procedure is considered surgery. Before the
surgery begins, you will undergo either general anesthesia or spinal anesthesia
to prevent pain during the surgery. You will also likely have a catheter, or
tube, inserted into your bladder in order to drain urine.
During the surgery, the surgeon will make a small incision,
or cut, inside the vagina and another small incision around the pubic hair line.
The surgeon will take the strip of tissue or synthetic material through the
incision and secure it around your urethra, either with or without stitches,
depending on the type of sling.
After the Surgery
Although it depends on your health history, this operation
is usually performed on an outpatient basis. In some cases, you will need to
stay in the hospital for one to two nights to recover. In most cases, you can
fully recover from this procedure within one to three months. You will probably
have a few follow-up appointments with your doctor. Be sure to keep these, and
follow any discharge and care instructions that you are given after surgery.