Fascial Sling for Stress Urinary Incontinence - Overview
This treatments helps to reduce stress urinary incontinence by attaching a sling underneath the urethra using a strip of tissue taken from your abdomen.
Who will this treatment be recommended to?
You will often be recommended pelvic floor exercises before offered this treatment. If these are unsuccessful surgery may be required. Alternative treatments will also be discussed with your urogynaecologist.
How do I perform these exercises?
Your pelvic muscles can be strengthened with kegel exercises, helping to reduce the extent of vaginal prolapse. To perform these exercises, tighten your pelvic muscles as if you are trying to hold back urine. Hold the muscles tight for a few seconds and then release. Repeat this 10 times. You can do this up to four times a day and these exercises can be done anywhere. For more information please click here.
How effective is Fascial Sling for treating Stress Incontinence?
A fascial sling may not completely stop stress incontinence but should improve it. Some patients (10-20%) will not be cured by the treatment. There is also a risk of stress incontinence recurring (about 10%). To help with this we recommend practising pelvic floor exercises as mentioned above.
Risks of Fascial Sling:
Risks/Complications
- Unsuccessful Treatment - This treatment is unsuccessful for 10-20% of women.
- Difficulty emptying the bladder - Around 5% of women experience issues emptying their bladder following treatment. In this case you will be sent home with a catheter to empty the bladder for up to a week. The difficulty should subside after this period. If not, options will be provided.
- Bladder Problems - Incontinence usually improves following surgery, but can sometimes become worse.
- Bladder Injury - There is a low risk that the bladder could be damaged during operation. However, this can usually be repaired during the same operation, and you need a catheter to drain the bladder for ten days so it can heal properly.
- Pain during sexual intercourse or pain lasting over 6 months - This is very rare but can be due to the change in the position of the vagina.
Pre/Post Procedure Instructions:
What happens before my surgery?
A pre-assessment appointment, a few days prior to your procedure, may also be required. This can involve having blood tests and a general health check-up. This is also a good opportunity to ask any questions about your surgery.
What should I expect following my procedure?
You should be able to go home the same day as your procedure, before this:
- Once you can eat drink and pass urine comfortably you can go home.
- Catheter - You may need a catheter to drain the bladder - you can go home with a catheter for up to a week.
- Drip - You may require a drip to remain hydrated following your procedure. This is usually removed within 24 hours.
- Drain - This may be required if there is excessive bleeding.
- You will be encouraged to walk around to reduce the risk of DVT (Deep Vein Thrombosis)
Recovery:
- Bath or shower as normal
- Do not use tampons for 6 weeks and avoid douching the vagina.
- You will probably feel tired during the day for a month or so, this will gradually improve.
- Avoid constipation and heavy lifting to reduce strain on the sling. To avoid constipation, drink plenty of water and eat fruit and green vegetables.
- After 6 weeks you should start to slowly increase your level of activity. You should be back to your normal level after 3 months.
- You can return to work in a light job after 6 weeks, and a busy job in 12 weeks. Avoid unnecessary heavy lifting.
- You can start having sexual intercourse again after 6 weeks but you may wish to use lubrication to reduce pain.
