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A urethral sling is a device that is surgically implanted to stabilize the pelvic tissues and organs of women. The surgery that implants this device can help treat urinary incontinence and uterine prolapse. An alternative treatment to the placement of the urethral sling is urethral bulking injections. [1]
Transvaginal mesh, also known as midurethral or bladder neck sling for SUI repair, can be used to support the urethra or the neck of the bladder in two surgical approaches, namely the retropubic and transobturator. In the retropubic approach, two incisions above the pubic bone and one incision in the vagina are performed. [14]
The transobturator tape (TOT or Monarc) sling procedure aims to eliminate stress urinary incontinence by providing support under the urethra. The minimally-invasive procedure eliminates retropubic needle passage and involves inserting a mesh tape under the urethra through three small incisions in the groin area.
When operating a pelvic organ prolapse, introducing a mid-urethral sling during or after surgery seems to reduce stress urinary incontinence. [13] Transvaginal repair seems to be more effective than transanal repair in posterior wall prolapse, but adverse effects cannot be excluded. [14] According to the FDA, serious complications are "not rare ...
Women and men that have persistent incontinence despite optimal conservative therapy may be candidates for surgery. Surgery may be used to help stress or overflow incontinence. [9] Common surgical techniques for stress incontinence include slings, tension-free vaginal tape, bladder suspension, artificial urinary sphincters, among others. [9]
Urethral bulking involves injecting an inert material into the wall of the urethra to relieve the symptoms of urethral hypermobility. This technique is less invasive than surgery with lower risk of adverse events, however it has a lower cure rate for stress incontinence than other methods.