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Slings For Repairing Incontinence Problems

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Women leak urine for a variety of reasons. Your diet, your activity, your weight, your anatomy, how many kids you have had, how much lifting you do, how many Kegel's exercises you have done, the medications you are on, whether you need more estrogen: the list of reasons for leaking a bit of pee goes on and on! And it's something you and your gyno can discuss at length. A study that looked at some solutions short of surgery had some interesting conclusions:

ATLAS: Ambulatory Treatments for Leakage Associated With Stress
focused on how much the patients thought they improved, and actually in their hands behavioral therapy worked better and resulting in greater patient satisfaction and fewer leaks than using a pessary at 3 months. Of course doing both is probably the best for many women! And then comes the discussion of whether you should have surgery if none of this is working.

Bladder slings then can be considered if the general surgeries are not working. These slings are an operation, they insert the sling through a small vaginal incision, with or without small incisions on the inner leg, and placed either at the right where the bladder joins the urethera, in the middle or the very far end of the urethra. The purpose is extra support for the urethra if you leak when you cough or sneeze or jump. These bladder neck slings can be made of either biologic materials (including the patient's own tissue) or synthetic mesh, and there has been a trend to use more synthetic mesh for these operations. In the past there were abdominal surgeries that repaired this, and with a large bladder drop there is additional surgery called an anterior repair which fixes the drop. This all would have to be discussed with your gyno.


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