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Bladder Sling

AMBULATORY CARE:

What you need to know about a bladder sling procedure:

A bladder sling procedure is surgery to treat urinary incontinence in women. The sling acts as a hammock to keep your urethra in place and hold it closed when your bladder is full. The urethra is the tube that goes from your bladder to the outside. A sling may be a thin strip of mesh placed under the urethra. The sling may instead be made from a piece of your tissue taken from your abdomen or thigh. The sling supports your urethra during physical activity or when you sneeze or cough to prevent leakage.

How to prepare for a bladder sling procedure:

Your healthcare provider will talk to you about how to prepare for surgery. He or she may tell you not to eat or drink anything after midnight on the day of your surgery. He or she will tell you what medicines to take or not take on the day of your surgery. If you take aspirin or other blood thinners, you may need to stop taking them 5 to 7 days before your surgery. You may be given an antibiotic through your IV to help prevent a bacterial infection.

What will happen during surgery:

  • You may be given general anesthesia to keep you asleep and free from pain during surgery. You may instead be given anesthesia to numb the surgery area. With this anesthesia, you may still feel pressure or pushing during surgery, but you should not feel any pain. A small incision will be made in your vagina to insert the sling. You may also have small incisions in your lower abdomen or thigh.
  • The sling will be placed under your urethra and around the area where your urethra and bladder meet. One end of the sling will be on each side of your urethra. The ends of the sling may be stitched to your abdominal wall. Small pins or screws may instead be placed in your pelvic bone to hold the sling in place. Your healthcare provider will check for correct placement of the sling. Any small incisions will be closed with stitches or medical glue. A bandage with antibiotic medicine may be put inside your vagina to help prevent infection.

What will happen after a bladder sling procedure:

You may have vaginal bleeding or discharge for up to a week after your surgery. Use sanitary pads. Do not use tampons. You may have some pelvic discomfort after your surgery. You may find it hard to urinate or it may feel different than it did before surgery. You may urinate more slowly than you did before surgery. You may need to use a catheter to empty your bladder a few times a day until your function returns. You may have a Foley catheter for a short period of time to drain your urine. You may need to avoid any activity that can strain your surgery area. This includes heavy lifting, strenuous exercise, or straining for a bowel movement.

Risks of a bladder sling procedure:

You may bleed more than expected or get an infection. The sling may break down and you may need another procedure to fix it. You may develop long-term pain. Your bladder or other pelvic organs may be damaged by tools or mesh used during the procedure. You will need surgery to remove the mesh and repair any damage. You may have an allergic response to the anesthesia medicine. You may have trouble urinating, or you may leak urine. You may develop urgency to urinate or urinate often. You also may have pain during or after sex. You may develop a hernia at the site where tissue was taken to make the sling. You may also have pain at the site. You may get a blood clot in your limb. This may become life-threatening.

Call 911 for any of the following:

  • You have sudden trouble breathing.

Seek care immediately if:

  • Your bleeding gets worse.
  • You have yellow or foul-smelling discharge from your vagina.
  • You cannot urinate, or you are urinating less than what is normal for you.
  • You feel confused.

Contact your healthcare provider if:

  • You have a fever.
  • You do not feel like you are able to empty your bladder completely when you urinate.
  • You have pain or pressure in your vagina.
  • You feel the need to urinate very suddenly.
  • You have burning or stinging when you urinate.
  • You have blood in your urine.
  • Your skin is itchy, swollen, or you have a rash.
  • You have questions or concerns about your condition or care.

Medicines:

  • Prescription pain medicine may be given. Ask your healthcare provider how to take this medicine safely. Some prescription pain medicines contain acetaminophen. Do not take other medicines that contain acetaminophen without talking to your healthcare provider. Too much acetaminophen may cause liver damage. Prescription pain medicine may cause constipation. Ask your healthcare provider how to prevent or treat constipation.
  • Take your medicine as directed. Contact your healthcare provider if you think your medicine is not helping or if you have side effects. Tell him or her if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.

Self-catheterization:

You may need to put a catheter into your bladder after you urinate to empty any remaining urine. A catheter is a small rubber tube used to drain urine. Healthcare providers will teach you how to put the catheter in safely. This may be needed until you are completely emptying your bladder when you urinate.


Foley catheter:

You may have a Foley catheter for a short period of time. The Foley is a tube put into your bladder to drain urine into a bag. Keep the bag below your waist. This will prevent urine from flowing back into your bladder and causing an infection or other problems. Also, keep the tube free of kinks so the urine will drain properly. Do not pull on the catheter. This can cause pain and bleeding, and may cause the catheter to come out.

Activity:

Do not lift heavy objects for 6 weeks after your procedure. Do not have sex for 4 to 6 weeks. Do not use a tampon for 4 weeks. Ask your healthcare provider when you can return to work or your usual activities.

Do pelvic muscle exercises:

These are also called Kegel exercises. These exercises help strengthen your pelvic muscles and help prevent urine leakage. Tighten the muscles of your pelvis and hold them tight for 5 seconds. Then relax for 5 seconds. Gradually work up to tightening them for 10 seconds and relaxing for 10 seconds. Do this 3 times each day.

Keep a record:

Keep a record of when you urinate and if you leak any urine. Write down what you were doing when you leaked urine, such as coughing or sneezing. Bring the record to your follow-up visits.

Prevent constipation:

Drink liquids as directed. You may need to drink more water than usual to soften your bowel movements. Eat a variety of healthy foods, especially fruits, vegetables, and other foods high in fiber. You may need to use an over-the-counter bowel movement softener.

Follow up with your healthcare provider as directed:

You may need a test to check how much urine remains in your bladder after you urinate. This will help show how the sling is working. Write down your questions so you remember to ask them during your visits.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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