What are Suburethral Slings?
BDS (Bachelor of Dental Surgery), 10 years of experience
What is the meaning of Suburethral Slings?
Suburethral sling surgeries are one of the traditional surgical procedures done primarily for the treatment of stress urinary incontinence or an overactive bladder. Stress urinary incontinence is the leakage of urine during activities like laughing, sneezing, coughing, exercising, or lifting heavy objects. Suburethral sling procedures help in closing the urethra and the bladder neck. The bladder is the part of the body that stores urine. The urethra is the tube that carries urine from the bladder to the outside. The bladder neck is the part of the bladder that connects to the urethra. Suburethral slings are only recommended by the doctor when other conservative approaches have failed in treating stress urinary incontinence.
In this article, we will be discussing suburethral slings in detail-
- What are the different types of Urethral Slings?
- What is the purpose of Suburethral Slings?
- What is the diagnostic procedure for Suburethral Slings?
- What is the preparation for Suburethral Slings?
- What is the procedure for Suburethral Slings?
- How to care after Suburethral Slings?
- What are the risks of Suburethral Slings?
- What is the cost of Suburethral Slings Surgery in India?
What are the different types of Urethral Slings?
The different types of slings include:
Conventional or traditional slings: Conventional slings are made from any one of the following materials:
- Animal tissue
- Synthetic material
- Tissue from the patient’s body
- Tissue from a cadaver (a corpse)
Tension-free slings or mid-urethral slings: These types of slings are usually made of synthetic mesh. This material is placed around the urethra by the doctor. It acts like a hammock to support and lift the urethra and bladder neck. The doctor uses the surrounding tissues in the body to keep it in place instead of using stitches (sutures) to secure it.
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What is the purpose of Suburethral Slings?
Suburethral slings are used in the treatment of the following cases:
- Stress urinary incontinence
- An overactive bladder
- Urinary incontinence (leakage of urine without any trigger)
- Sagging of the urethra and/or neck of the bladder causing urinary incontinence
- Urinary incontinence complicated by factors like obesity
- Urinary incontinence caused due to problems associated with the muscular portion present at the bladder’s outlet (known as sphincter muscles)
- Urinary incontinence with a history of failed surgeries previously
- Recurrence of stress urinary incontinence even after treatment by conventional methods
( Know more about- What is Stress Urinary Incontinence ? )
What is the diagnostic procedure for Suburethral Slings?
- Physical examination: The doctor will check you physically and note down your symptoms. You will also be asked about your past medical history.
- Urodynamic study: These tests are done to check how well the bladder, sphincters, and urethra can store and release urine.
- 24-hour pad test: This test helps in checking the amount of urine that is leaked in a 24 hour period by the number of pads that are soaked in that period.
- Cystoscopy: A tube known as a cystoscope is inserted by the surgeon through the urethra into the bladder to view the inside of the bladder and urethra.
- Electrocardiogram (EKG): This test helps in determining the conduct of the heart of the patient.
- Blood tests: Routine blood tests are advised to check the normal blood parameters and if there is a presence of any underlying medical condition.
- Urine tests: Urine tests are recommended to check for any urinary infections.
- Imaging tests: The doctor may recommend imaging tests like CT scans, MRI scans, and ultrasounds to obtain clear images of the internal organs of the body.
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What is the preparation for Suburethral Slings?
- The doctor should know about any pre-existing medical conditions that you may be suffering from.
- The doctor should know about any medications or supplements that you may be currently taking.
- The doctor will advise stopping blood-thinning medications like aspirin and warfarin a few days before the surgery.
- Avoid eating or drinking anything at least 8 hours before the surgery.
- Stop smoking at least two weeks before the surgery.
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What is the procedure for Suburethral Slings?
The suburethral slings can be placed in the following ways:
Retropubic method (also known as tension-free vaginal tape method:
- A small cut (incision) is made by the surgeon inside the female vagina, under the urethra.
- Two tiny cuts are made above the pubic bone, which is just big enough for a needle to fit.
- A needle is then used to put the sling under the urethra and behind the pubic bone.
- Stitches (sutures) or skin glue is then used to close the incisions.
Transobturator method:
- Small cuts are made by the surgeon inside a woman’s vagina, under the urethra, and one on either side of the labia (the folds of skin on either side of the vagina).
- The sling is then placed under the urethra.
Single-incision mini method:
- The surgeon makes one small incision in the vagina and then puts a sling through it.
- No stitches are used for attaching the sling.
- Scar tissue forms around it to keep it in place.
Traditional sling surgery:
- A strip of tissue is taken from the patient’s thigh or stomach to make the sling, or tissue may be obtained from a donor.
- Two cuts are then made by the surgeon, one in the vagina and the other one in the stomach.
- The sling is stretched through the cut in the stomach, and then stitched inside the stomach wall.
Sling surgery in men:
- In the case of men, a small cut is made between the scrotum (a bag of skin that holds and protects a man’s testis) and anus (an opening through which stool passes out of the body) of the man.
- A sling is then placed around the urethral bulb (the enlarged urethral end in men). This helps in squeezing and lifting the urethra, which helps in preventing urine leakage.
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How to care after Suburethral Slings?
- You may go home on the same day of the surgery, or two to three days after the surgery if there are no complications.
- A thin, flexible tube known as a catheter is placed into the bladder through the urethra or the belly wall. It allows the draining of urine post-surgery.
- Strenuous activities should be avoided for 2 to 4 weeks after the surgery.
- It is normal to have some pain and cramping in the abdomen after the surgery.
- The doctor will prescribe pain medications to relieve the pain and discomfort that occurs for the first few days following the surgery.
- Some patients may experience constipation following the surgery.
- To relieve constipation include fruits, vegetables, and whole grains in your diet, as these foods are high in fiber content.
- Drink lots of fluids throughout the day.
- Schedule a daily routine for having a bowel movement.
- Avoid sexual intercourse for 4 to 6 weeks after the surgery.
- You will recover completely one to three months after the surgery.
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What are the risks of Suburethral Slings?
The complications associated with suburethral slings are:
- Infection at the site of incision
- Internal bleeding
- Urinary tract infections
- Difficulty in urinating after the surgery
- Injury to the nearby organs like bladder, urethra, vagina, or ureters (tubes carrying urine from the kidney to the urinary bladder)
- Sudden, strong urge to urinate
- Worsening of urine leakage
- Constipation
- The abnormal passage between the bladder or urethra and vagina, known as a fistula
- Breaking down of the synthetic material that is used for the sling
- Erosion of the synthetic material through the normal tissue
- Prolapsed vagina (when the vagina slips out of its normal position)
- Painful sex
( Know more about- What is Hematuria ( Blood in Urine )?
What is the cost of Suburethral Slings Surgery in India?
The total cost of suburethral slings surgery in India can range from around INR 30,000 to INR 1,50,000, depending on the type of treatment done. However, many prominent hospital doctors in India specialize in suburethral slings surgery. But the cost varies across different hospitals.
If you are coming from abroad, apart from the cost of suburethral slings surgery, there will be an additional cost of living in a hotel and the cost of local travel. After surgery, the patient is kept for two days in the hospital and seven days in the hotel for recovery. So, the total cost of suburethral slings surgery in India comes from a total of INR 50,000 to INR 1,70,000.
We hope that we could answer all your questions regarding Suburethral Slings through this article.
If you need more information related to suburethral slings, then you can contact a Urologist.
We only aim to provide you with information through this article. We do not recommend any medicine or treatment. Only a doctor can give you the best advice and correct treatment plan.
