Urethral Slings Specialist in NYC

Stress Urinary Incontinence (SUI) is a condition among those who have poor bladder control and who loose urine in certain stress situations like coughing, sneezing or exercising. To help correct this problem and restore bladder control, surgical procedures called urethral sling procedures can be used to create a sling around the neck of the bladder and the urethra (tube that carries urine from the bladder) to keep the bladder closed during stress situations.

Depending on the type of sling used, and your physician’s direction, these procedures may be performed in a hospital or outpatient surgery center.

Stress Urinary Incontinence Treatment

Urethral sling procedures involve using strips of a patient’s own body tissue or a synthetic mesh to create a sling to cradle and support the bladder and urethra. Types of urethral sling procedures include:

Tension-free slings

In this procedure a synthetic mesh material initially holds the sling in place and the scar tissue that eventually forms in and around the mesh keeps it from moving. There are three approaches for creating tension-free slings which include:

• Retropubic (also known as Suprapubic). In this approach a small incision is made inside the vagina. Two small openings are then made above the pubic bone through which the sling is inserted and placed inside the body. Stitches are not needed to hold the sling in place.
• Transoburator. This newer approach lowers the risk of injury to the urethra and bladder. In it, the surgeon uses a similar vaginal incision, but sling arms are not passed between the pubic bone and bladder. Here too, stitches are not needed to hold the sling in place.

Adjustable slings

Under study is a sling that can be adjusted during and after surgery. Once the sling is in position, and the patient is alert, sling tension can be adjusted according to a patient’s needs. Should adjustments need to be made months or years after surgery, a local anesthetic is all that is required to reach the adjustable portion of the sling.

Conventional slings

With this type of sling, the surgeon inserts a sling through an incision in the vagina and directs it around the neck of the bladder. Made from synthetic material, a patient’s own tissue or donor tissue, the ends of the sling are passed through a small incision in the abdomen and stitched to pelvic tissue or to the abdominal wall. These slings may require larger incisions as well as an overnight hospital stay.