Female urinary incontinence

The vaginal sling procedure

Urinary incontinence happens when you lose control of your bladder leading to urine leaks at day or night. About 25% to 45% of women suffer from urinary incontinence and this rate increases with age.

Two types of urinary incontinence exist : stress urinary incontinence and overactive bladder syndrome.

Stress urinary incontinence

Stress incontinence (SI) is the most common type of incontinence suffered by women. It results from weak muscles in the pelvic floor or a weak sphincter muscle that cause the leakage of urine from the bladder.

When abdominal pressure increases (in case of activities such as coughing, sneezing, laughing or exercising), pressure on the bladder increases too and some urine leaks can appear if the sphincter is too weak for instance.

Overactive bladder syndrome

Overactive bladder syndrome is characterised by a rise in pressure or abnormal contractions of the bladder. These contractions lead to an urgent need to urinate and can sometimes be painful.

These uncontrolled contractions may be accompanied by a rise in the bladder pressure. When the bladder pressure becomes higher than the sphincter's one, the latter (even if it works properly) is not able anymore to contain urine and some leaks start appearing.

How are these disorders diagnosed?

These two types of urinary disorders are diagnosed by the urologist based upon an inquiry and a pelvic exam during which leaks are being repeated after having filled the bladder. An urodynamic testing may also be prescribed in order to measure the bladder activity.

The surgery process

In case of a stress urinary incontinence, a surgical solution exists : the vaginal sling procedure. The sling supports the urethra and helps keep it closed — especially when abdominal pressure increases — so that you don’t leak urine.

During the procedure performed under general or spinal anaesthesia, the surgeon makes a small incision inside the vagina to put in place the synthetic tape. TOT (Transobturator Tape Procedure) involves the placement of this piece of mesh around the pubic bones underneath the urethra. The piece of mesh can also be placed behind the pubic bone. In that case we talk about Transvaginal Tape Procedure

The results of these two sling procedures are equivalent. The choice made by the surgeon between the two procedures will depend on the outcomes of the pelvic exam or the urodynamic testing.

The scars in the vagina and pubic area are closed by resorbable sutures.

Lenght of the stay

1 day

This operation is carried out on an outpatient basis (one-night hospital stay).

Surgical follow-up

D+1

The urinary catheter put in place during the operation is removed the same day or the day after.

Physical efforts

Only after 6 weeks

Physical efforts are contraindicated during the 6 weeks following the operation to ensure a solid integration of the sling and proper healing.