PROLENE SUBURETHRAL SLING SURGERY

This procedure is also known as transvaginal tape (TVT), also Sparc, Monarc, Miniarc, & 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 or around the labia. These wounds are closed with steristrips. The operation is performed under local anaesthetic, or sedation, so that the exact tension on the sling can be determined while you cough in order to prevent leakage. You will usually only be in hospital as a day case, with recovery for 2 weeks. Occasionally you may need a catheter overnight if the bladder temporarily will not empty.

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 90- 95%.

2. The bladder may be more irritable, with new symptoms of urgency and frequency in about 10-15% of women. These often settle over several months.

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 a second operation after one week to loosen the sling.

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.