Most invasive and not necessarily permanent
According to the Cleveland Clinic, approximately 11 percent of patients seeking treatment for urinary incontinence will undergo surgery.
Sling surgery for stress urinary incontinence is often done as an outpatient procedure. One option for stress incontinence is to place the bladder in a “sling” – a piece of tissue or synthetic material is used to create a sling around the bladder neck and urethra in order to provide support to keep the urethra closed in order to prevent leaks. As with any surgical procedure, please discuss thoroughly with your physician the benefits and possible complications that may exist.
The Cleveland Clinic describes different types of sling procedures:
- Tension-Free Transvaginal Tape (TVT): When a woman has finished having children, a minimally invasive treatment can fix stress urinary incontinence (SUI), allowing her to return to a full and active life. TVT can stop urine leakage by supporting the urethra with a tape-like strip of mesh. Used in an approximately 30-minute outpatient procedure, it has shown proven results for the treatment of SUI. A mesh-like tape is inserted under the urethra to create a supportive sling. This provides support and allows the urethra to remain closed when appropriate, preventing urine loss during sudden movements or exercise. Patients may be able to go home as early as a few hours after the procedure and patients can expect a short recovery period. The best way to determine if you are a candidate for this treatment is to ask your doctor.
- Transobturator Tape (TOT) Sling: First developed in Europe, the transobturator tape (TOT) sling procedure is meant to eliminate stress urinary incontinence by providing support under the urethra. The minimally invasive procedure involves inserting a mesh tape under the urethra through three small incisions in the groin area. Studies have shown that the safer, more efficient tot sling procedure decreases the risks of bowel and bladder injury and major bleeding and has an excellent cure rate.
- Mini-Sling: The Mini Sling procedure is the latest and least invasive treatment for stress urinary incontinence. The five to 10-minute procedure utilizes the same concepts of the tension-free tape mid-urethral slings, but involves a single incision. This procedure has displayed a high cure rate and reduces the risk of bowel injury, bladder injury, and major bleeding because it bypasses retropubic needle passage altogether.
Note: Does not treat Urge Incontinence and does nothing to strengthen the pelvic floor muscles.
Bladder neck suspension
This procedure will support your bladder neck and urethra. The bladder neck is an area of muscle where the bladder connects to the urethra. The surgery involves an abdominal incision, so it can be done during general or spinal anesthesia.
If a woman has mixed incontinence as well as a pelvic organ prolapse, surgery may include a combination of sling and prolapse surgery.
Artifical urinary sphincter
For men, a small, fluid-filled right is implanted around the bladder neck to keep the urinary sphincter shut until you’re ready to urinate. When you do urinate, you press a valve implanted under your skin that causes the ring to deflate and allows urine to flow.