Transvaginal Sling for Incontinence

The sling is usually made from synthetic material or a strip of your own body tissue. It acts as a layer of support so that the urethra remains closed off and is not as leaky when there is increased pressure in the abdomen (laughing, coughing, sneezing and exercising).

Your surgeon will discuss the benefits and risks of different surgical materials and different approaches for the placement of a sling.

The procedure takes place in the operating room at the hospital or in an outpatient surgery center. Most patients go home the same day. Recovery times vary with different procedures.

• You will be admitted to the hospital on the day of your surgery.
• If you are on Coumadin, aspirin, ibuprofen, medications for arthritis or inflammation, please notify our office, as patients typically need to stop these for surgery.
• You may be instructed to stop taking other medications prior to surgery. Ask your doctor to be sure.
• If you take antibiotics prior to dental work or have an orthopedic prosthesis, or if you were told by another physician to take antibiotics prior to surgery, please let your doctor know.
• No eating or drinking after midnight the night before your surgery except for blood pressure or medications as mentioned above. No alcohol 24 hours prior to surgery.
• You will be receiving anesthesia for this procedure. An anesthesiologist will meet with you prior to surgery. Risks of this procedure include but are not limited to complications from general anesthetic, bleeding, infection, urinary retention, and continued urinary incontinence.

You will awaken from surgery with a catheter, which drains urine from your bladder. You will be given pain medications in the hospital to relieve your discomfort as well as antibiotics to continue taking for a few days.

Diet:

There are no dietary restrictions. We encourage you to increase your fluid intake.

Activity:

• Do not lift anything heavier than 10 pounds for one month. We recommend you be cautious not to routinely lift more than 35 pounds for the rest of your life to prevent the sling from stretching out.
• It is OK to shower after discharge from the hospital. No baths for two weeks postoperatively.
• It is OK to climb stairs when discharged from the hospital.
• Walking is good exercise, and it improves circulation. Do not overdo it! Go easy at first and slowly increase the distance as you feel better. In the long run, exercise will help improve fitness and manage weight. Staying at a healthy weight will help the operation work better and last longer.
• Avoid any heavy lifting or strenuous exercise for at least six weeks to give time to heal.
• No sexual activity for 4-6 weeks.
• No driving for one week and until you are no longer taking narcotic pain medications.
• If you smoke, now is a good time to stop. Smoking can increase healing complications for this type of surgery.

Pain Medication:

You may be given a prescription for pain medication when discharged from the hospital. As your activity increases you may experience a period of increased soreness. This is normal.

Antibiotics:

You may be given a prescription for antibiotics to be taken at home when discharged from the hospital. Please take all your prescribed medication.

Bowels:

Avoid straining during a bowel movement. You may be given a stool softener to promote regular bowel movements. Over the counter Milk of Magnesia 30 cc or suppositories are recommended if your stools are hard.

Catheter:

You might go home with a catheter. The catheter may be either supra-pubic (a tube coming directly out of your bladder through the belly) or in your urethra. A small number of women have some difficulty urinating on their own after surgery, but this typically resolves as the inflammation from the operation gets better. If you are sent home with a catheter, you will be instructed on catheter care and how and when the catheter will be taken out (typically a few days after surgery). You may experience some leakage around the catheter, this is normal. Always make sure the tubes are not kinked so the urine drains from the bladder freely.