PROLENE SUBURETHRAL SLING SURGERY

This procedure is also known as transvaginal tape (TVT, also Sparc, Monarc, & Secure). A sling procedure is designed to cure urinary incontinence that is caused by coughing, sneezing, laughing or exercise (stress incontinence). It may not cure urinary incontinence that is caused by urgency (or rushing to the toilet) or frequency (going to the toilet many times during the day or night).

The aim of this operation is to cure incontinence by lifting up the neck of the bladder and supporting it with a sling made of prolene. This sling, attached to the abdominal wall, is then passed underneath the urethra to provide this support. The operation is performed from the vagina with just two small cuts (1cm) in the lower abdomen below the pubic hairline. These wounds are closed with dissolving sutures. The operation is performed under local anaesthetic so that the exact tension on the sling can be determined while you cough in order to prevent leakage. A small catheter is placed in the urethra to drain the bladder overnight. You will usually be in hospital for 2 days, and recovering for 2 weeks. Occasionally you may need to stay longer if the bladder can not empty properly.

Some Common Questions

What are the complications of sling surgery?

There are five main complications:

1. The procedure may not work. The success rate is about 80- 90%.

2. The bladder may be more irritable, with new symptoms of urgency and frequency in about 10-15% of women.

3. Infection of the urine or wounds (treatable with antibiotics).

4. The bladder may be more difficult to empty, with about 1-2% of women needing help to empty their baldder by self-catheterisation.

5. The body may react to the prolene sling and require removal (about 1-2%).

Other rarer complications include: severe bleeding requiring blood transfusion, blood clots in the calf muscles or lungs, anaesthetic complications, and intraoperative damage to nearby structures such as bowel/bladder/blood vessels/ureter.

When can I resume intercourse?

Sexual intercourse should be avoided until after your first check up at around six weeks. This is because the surgery will have slightly altered the shape of your vagina and intercourse in the first six weeks may be uncomfortable.