Publication - Advice and guidance

Synthetic Vaginal Mesh Mid-urethral Tape Procedure for the Surgical Treatment of Stress Urinary Incontinence in Women

Published: 25 Jun 2014
Part of:
Health and social care
ISBN:
9781784126131

This Booklet gives detailed information about the synthetic mid-urethral sling procedure.

32 page PDF

2.1 MB

32 page PDF

2.1 MB

Contents
Synthetic Vaginal Mesh Mid-urethral Tape Procedure for the Surgical Treatment of Stress Urinary Incontinence in Women
What is the Synthetic Vaginal Mesh Tape Procedure?

32 page PDF

2.1 MB

What is the Synthetic Vaginal Mesh Tape Procedure?

This operation involves placing a piece of synthetic material, like a sling, under your urethra to support it.

Intended benefits

  • Published studies have shown similar success results in achieving cure or improvement of stress urinary incontinence to non-tape surgical procedures.
  • The procedure is not intended to improve symptoms of an overactive bladder (urinary frequency, urgency or waking up at night to pass urine).

During the procedure

  • You will be given a general, spinal or local anaesthetic and/or sedation. The type of anaesthesia will be discussed by your anaesthetist/surgeon and depends on the nature of your surgery, your health as well as your wishes.
  • The procedure is usually performed in the Day Surgery Unit of your hospital and most patients go home the same day. A synthetic sling is inserted through a small (1-2 cm) cut in the vagina, to support the urethra. The surgeon then makes 2 smaller cuts just above the pubic area (during a retropubic procedure) or on the inside of both thighs (during a transobturator procedure) and passes the synthetic sling through them. The single-incision* procedure is similar to the transobturator one but there are no cuts outside the vagina.
  • The procedure takes around 20-30 minutes. A cystoscopy (camera looking into bladder) will be performed to ensure your bladder has not been injured during this process. The mesh tape is meant to remain in place permanently, i.e. remain inside the body for life.

*Single-incision or Mini Slings are recommended for use only within research context.

There are two main types of vaginal mesh tape procedures for urinary incontinence:

Comparison

Retropubic tape

Transobturator tape

Vaginal mesh tape procedures for urinary incontinence: Retropubic tape

Vaginal mesh tape procedures for urinary incontinence: Transobturator tape

Outside cuts

In the lower abdomen above the pubic bone eg Retropubic/TVT

In the groin area eg Obturator/TVT-O

Success rate

Evidence of longer-term success rates

Similar success rate in the short and medium-term

Bladder injury during surgery

Higher risk*

Lower risk*

Bladder emptying problems

Higher risk*

Lower risk*

Chronic pelvic pain

Lower risk*

Higher risk*

*Please see below for details of the risks and complications

After the procedure

You will be taken back to the ward, where the nurses will look after you. Painkillers will be given as required and you may eat and drink straightaway on return from theatre. You will have a routine bladder ultrasound scan and once staff are happy that the bladder empties well, most women can go home on the same day. If not, a catheter (tube that goes into your bladder) may need to be used for some time. There may be slight vaginal bleeding (like the end of a period) for a few days. You may have a vaginal gauze placed in your vagina to help control any bleeding.

Light activities may be resumed after two weeks, normal activities after four weeks. More strenuous tasks and heavy lifting should be avoided for six weeks. Return to work will depend on the type of work you do. Please ask your doctor for his/her opinion and if you require a 'Fitness for work' certificate.

You should refrain from sexual intercourse and inserting any creams or devices for six weeks following your procedure, unless recommended by your doctor. It is important that you avoid constipation by ensuring you drink plenty of fluid and eat fruit and vegetables. Laxatives may be required to help your bowels work better. It is important to continue with the physiotherapy advice you have been given prior to your procedure.

A follow-up appointment will be made in 2-4 months time (in clinic or by phone).

For more information on recovery, please ask your doctor for the detailed Recovery Leaflet or visit the following web link: http://www.rcog.org.uk/files/rcog-corp/Mid-urethralSlingRecoveringWell0710.pdf


Contact

Email: Kerrie Mulloy