Sling Surgery for Incontinence
Urinary incontinence is the inability to control the release of urine from your bladder. Some people experience occasional, minor leaks — or dribbles — of urine, others wet their clothes frequently.
Types of Urinary incontinence include:
- Stress incontinence. This is loss of urine when you exert pressure — stress — on your bladder by coughing, sneezing, laughing, exercising, or lifting something heavy. Stress incontinence occurs when the sphincter muscle of the bladder is weakened. In women, physical changes resulting from pregnancy, childbirth and menopause can cause stress incontinence. In men, removal of the prostate gland can lead to stress incontinence.
- Urge incontinence (overactive bladder). This is a sudden, intense urge to urinate, followed by an involuntary loss of urine. Your bladder muscle contracts and may give you a warning of only a few seconds to a minute to reach a toilet. With urge incontinence, you may need to urinate often, including throughout the night. Urge incontinence may be caused by urinary tract infections, bladder irritants, bowel problems, Parkinson’s disease, Alzheimer’s disease, stroke, injury, or nervous system damage associated with multiple sclerosis.
- Overflow incontinence. If you frequently or constantly dribble urine, you may have overflow incontinence, which is an inability to empty your bladder. Sometimes you may feel as if you never completely empty your bladder. When you try to urinate, you may produce only a weak stream of urine. This type of incontinence may occur in people with a damaged bladder, blocked urethra or nerve damage from diabetes, multiple sclerosis, or spinal cord injury. In men, overflow incontinence can also be associated with prostate gland problems.
- Mixed incontinence. If you experience symptoms of more than one type of urinary incontinence, such as stress incontinence and urge incontinence, you have mixed incontinence.
- Functional incontinence. Many older adults, especially people in nursing homes, experience incontinence simply because a physical or mental impairment keeps them from making it to the toilet in time. For example, a person with severe arthritis may not be able to unbutton his or her pants quickly enough. This is called functional incontinence.
- Total incontinence. This term is sometimes used to describe continuous leaking of urine, day and night, or the periodic uncontrollable leaking of large volumes of urine.
If you’re like the millions of Americans living with urinary incontinence, we know how disruptive it can be to your life and peace of mind. That’s why the urologists at McKenzie-Willamette Medical Center offer everything you need to take control.
The urologists at McKenzie-Willamette Medical Center specialize in the newest techniques, including bladder sling, a common outpatient procedure that provides a protective “hammock” to help prevent urinary leaks. It is especially effective for stress incontinence, where leakage is caused by certain movements like coughing, sneezing or lifting.
About the Sling Surgery
At your initial consultation, we may first recommend nonsurgical options, including bladder retraining; Kegel exercises to strengthen pelvic muscles or medication. But, if you’ve tried those without success, you may be a good candidate for sling surgery.
During the procedure, your surgeon creates and attaches a sling made of mesh or human tissue. The technique is different for women and men – both which have shown to be highly effective for long-term relief from stress incontinence:
Sling for Women
Your doctor makes one small incision inside the vagina, and one just above the pubic hair line or in the groin. The sling is passed under your urethra (the tube that urine passes through) and bladder neck (the part of the bladder that connects to the urethra). It is then either attached to the strong tissues in your lower belly or left in place to let your body naturally incorporate it into your tissue.
Often, the urologists at McKenzie-Willamette Medical Center can create a tension-free sling. That means that instead of using stitches, body tissue holds the sling in place. Eventually scar tissue forms in and around the sling to keep it from moving.
Sling for Men
Your urologist makes a small incision between the scrotum and anus and puts the sling around part of the urethral bulb (the enlarged end of the urethra in men). This will squeeze and lift the urethra, which helps prevent leaks.
Recovery & Follow-Up Care
We usually perform the procedure on an outpatient basis under general anesthesia, allowing you to leave the hospital the same day and recover comfortably at home. In certain cases, you may need to spend a night or two at the hospital.
Recovery time varies, usually around two to four weeks of healing before returning to activities that include heavy lifting or exercise. It may be up to six weeks before you’re able to resume sexual activity. You may need a temporary catheter after surgery to help drain urine while you heal.
Overall, sling surgery is generally considered safe and effective. As with any surgery, the urologists at McKenzie-Willamette Medical Center will discuss the risks and benefits of the procedure and help you make the best choice for your health and life.
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