Bladder Sling Procedures

WHAT YOU SHOULD KNOW:

A bladder sling procedure is surgery to treat urinary incontinence in women. A sling made from a piece of your muscle tissue is inserted during the surgery. The sling keeps your urethra in place and holds it closed even when your bladder is full.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

  • You may have an allergic response to the anesthesia medicine used during your procedure. During the procedure, your bladder or bowel may be injured. After the procedure, you may have pain, nausea, vomiting, bleeding, or bruising. You may get a wound infection or a urinary tract infection. You may have trouble urinating, or you may leak urine. You also may have pain during, or after having sex. The tissue used for your sling may break down, and you may need another procedure to fix it.

  • You may get a blood clot in your leg or arm. This can cause pain and swelling, and it can stop blood from flowing where it needs to go in your body. The blood clot can break loose and travel to your lungs or brain. A blood clot in your lungs can cause chest pain and trouble breathing. A blood clot in your brain can cause a stroke. These problems can be life-threatening.

  • Without the procedure, the muscles and tissues in your urinary tract may continue to weaken. Your symptoms, such as leaking urine, may get worse. You may have more trouble controlling when you urinate. Talk to your caregiver if you have questions or concerns about your procedure, condition, or care.

WHILE YOU ARE HERE:

Before your procedure:

  • Informed consent is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

  • An IV is a small tube placed in your vein that is used to give you medicine or liquids.

  • Vital signs: Caregivers will check your blood pressure, heart rate, breathing rate, and temperature. They will also ask about your pain. These vital signs give caregivers information about your current health.

  • Antibiotics: This medicine is given to help treat or prevent an infection caused by bacteria.

  • Pre-op care: You will be taken to the room where your procedure will be done and moved to a special table. You will lie on your back and your legs will be held up with supports.

  • Anesthesia: Anesthesia is medicine to make you comfortable during your procedure. Caregivers work with you to decide which anesthesia is best, and whether you will be awake or completely asleep.

    • General anesthesia: This is medicine that may be given in your IV or as a gas that you breathe. You may wear a face mask or have a tube placed in your mouth and throat. The tube is called an endotracheal tube or ET tube. Usually you are asleep before caregivers put the tube into your throat. The ET tube is usually removed before you wake up. You are completely asleep and free from pain during your procedure.

    • Local anesthesia: This medicine is given as a shot into your vaginal wall. It is used to numb the area and dull your pain. You may still feel pressure or pushing during the procedure after you get this medicine.

    • Regional anesthesia: Medicine is injected to numb the body area where the surgery or procedure will be done. You will remain awake during the surgery or procedure.

  • Foley catheter: A Foley catheter is a tube that is put into your bladder to drain your urine into a bag. The catheter is normally inserted after you have had anesthesia. The catheter may be left in for at least a day after your procedure.

During your procedure:

  • If your bladder sling will be inserted through your abdomen, a cut will be made in your lower abdomen. A strip of tissue may be taken from your abdominal wall to use as your sling. Another small cut will be made in your vaginal wall to insert the sling in the proper area. The sling will be placed under your urethra and around the area where your bladder and urethra meet. One end of the sling will then be on each side of your urethra. The ends of the sling may be stitched to your abdominal wall or screwed into your pelvic bone. When the sling is secured, your cuts will be closed with stitches.

  • If your procedure will be done through your vagina only, a small incision (cut) will be made in your vaginal wall. Your caregiver may use a special tool to keep your vagina open during the procedure. Small pins or screws may be placed in your pelvic bone to hold your sling in place. The sling will be inserted through the cut in your vaginal wall. The sling will be placed around your urethra and each end will be attached to your pelvic bone. Once the sling is secured in place, your cut will be closed with stitches.

  • Once your bladder sling is in place, it will hold and support your urethra and bladder. Your caregiver may use a special scope to check inside your urethra and bladder. The scope will show if the sling is in its proper place, and if your urine flow is blocked. A bandage with antibiotic medicine may be put inside your vagina to prevent infection. Your wound (surgery site) is covered with a bandage to keep it clean and dry, and to prevent infection.

After your procedure:

You will be taken to a room where you can rest until you are awake. Do not get out of bed until your caregiver says it is okay. Caregivers will watch you closely for any problems. If you are staying in the hospital, you will be taken back to your room. The bandage in your vagina may be removed the day after your procedure.

  • Medicine:

    • Pain medicine: Caregivers may give you medicine to take away or decrease your pain.

      • Do not wait until the pain is severe to ask for your medicine. Tell caregivers if your pain does not decrease. The medicine may not work as well at controlling your pain if you wait too long to take it.

      • Pain medicine can make you dizzy or sleepy. Prevent falls by calling a caregiver when you want to get out of bed or if you need help.


  • Deep breathing: This breathing exercise helps to keep you from getting a lung infection after your procedure. Deep breathing opens the tubes going to your lungs. You should deep breathe every hour while you are awake even if you wake up during the night.

    • You may be asked to use an incentive spirometer. This is a device that helps you take deeper breaths. Put the plastic piece into your mouth and take a very deep breath. Hold your breath as long as you can. Then let out your breath. Use your incentive spirometer 10 times in a row every hour while awake.


  • Pneumatic boots: These are plastic boots or leggings put on your feet or legs over pressure stockings or ace wraps. The boots or leggings are connected to an air pump machine. The pump tightens and loosens different parts of the pneumatic boots. This helps push the blood back up to the heart to keep clots from forming. You may need to wear the boots or stockings until you are able to walk on your own.

  • Urine output: Caregivers will need to measure the amount of urine you are making after your procedure. If you have a catheter, your caregiver will measure your urine in the catheter bag. If you do not have a catheter, caregivers may have you urinate in a urine container to be measured.

  • You will be able to drink liquids and eat certain foods once your stomach function returns after surgery. You may be given ice chips at first. Then you will get liquids such as water, broth, juice, and clear soft drinks. If your stomach does not become upset, you may then be given soft foods, such as ice cream and applesauce. Once you can eat soft foods easily, you may slowly begin to eat solid foods.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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