Bladder Sling Surgery: Weighing the Options

If you’re afraid to laugh, cough, or jump because you might pee a little, you’re not alone. An estimated 75% of women over age 40 suffer from some form of urinary incontinence. Though vaginal childbirth is a common cause of this condition, it’s not the only reason you leak a little when you move.

If you’re worried you’ll be wearing pads for the rest of your life, you may have considered bladder sling surgery. To help you make the right decision for your body, we broke down the types of urinary incontinence, what a bladder sling can do, and some of the risks involved in the surgery.

Understanding the Reasons Behind Urinary Incontinence

Understanding the reasons behind why you leak urine is a key factor in your intimate wellness. There are a number of reasons why you may notice an inability to hold in urine in different circumstances.

Stress Incontinence

Stress Incontinence is when you leak pee while jumping, coughing, laughing, or sneezing. Stress is any physical exertion that increases abdominal pressure. This type of incontinence happens when the urethral sphincter, the pelvic floor muscles, or both can’t physically hold urine due to some type of structural damage or weakness.

Women who gave birth vaginally are most likely to develop stress incontinence. Vaginal births may stretch and damage the pelvic floor muscle and surrounding nerves — which decreases the ability to control urine.

Another factor for stress incontinence is age and menopause. While maintaining vaginal wellness during menopause is important, our muscles naturally lose strength as we age, and the pelvic floor is no exception. Additionally, loss of estrogen during menopause can decrease elasticity in the pelvic floor, which may also play a role.

Urge Incontinence 

Urge incontinence is when you need to pee but your bladder isn’t full. This is an overwhelming feeling that you can’t control and you may have an accident before you reach the bathroom. Postmenopausal women tend to develop this condition, and it may be linked to changes in the bladder lining and weakening of the muscles due to loss of estrogen.

How Can a Bladder Sling Help Urinary Incontinence?

Slings are the most common way to treat stress incontinence and promote intimate care for women who have exhausted other methods. A sling works like a hammock that holds the urethra closed during physical exertion. This surgery is performed by a urogynecologist who accesses the urethra through the vagina.

The sling can be made of synthetic mesh or a woman’s own tissue. The procedure has a success rate of over 90 percent and is relatively low risk, though it’s important to note that complications may occur.

Is Vaginal Mesh The Same Thing as a Bladder Sling? 

Due to the high success rate of slings, transvaginal mesh “kits'' were introduced to treat pelvic organ prolapse. These “kits” were rapidly approved by the U.S. Food and Drug Administration (FDA) because of the similarity to slings.

In 2011, the FDA said transvaginal mesh may put women at a higher risk of complications and provided little benefit to their quality of life. Soon law firms caught on and started targeting patients who’d undergone the surgery. Ultimately, mesh products associated with increased risks were pulled off the market.

The mesh products still available on the market did not fall in this category and are endorsed by the majority of urogynecologists including bladder slings for incontinence and mesh placed from an abdominal repair prolapse.

What Are The Risks Associated With a Bladder Sling Procedure? 

Like any medical procedure, complications are rare but can occur. They may include:

• Difficulty urinating after surgery
• New symptoms or incontinence
• Injury to an organ 
• Internal bleeding
• Infection 

Due to the complicated nature of an urethral sling procedure, you may be at a greater risk of a damaged urethra or a failed procedure.  If your own tissue is used, you reduce the risk of rejection, and also reduce the risk of tissue erosion. However, this type of surgery has more downtime and requires more incisions.