Sling Procedures for Urinary Incontinence

Sling procedures are surgical procedures used to treat urinary incontinence, the accidental leakage of urine, when caused by pelvic organ prolapse.

Incontinence occurs when the urethra, the tube that carries urine out of the body, has dropped out of place or when the sphincter muscle that controls the opening and closing of the urethra is weak, allowing leakage.

In this procedure, a sling is placed under the urethra, like a hammock, to support the urethra and provide pressure to keep the urethra opening closed. The sling can be made from a man-made material such as mesh or, if necessary, the woman's own tissue or animal tissue.

Sling procedures, also known as pubovaginal or suburethral slings, are used when less invasive treatments are unsuccessful at relieving symptoms. They are performed through a vaginal incision and very small skin incisions by urogynecologists.

The two most common types of bladder slings today are:

TVT sling (tension-free vaginal tape sling). In this minimally invasive procedure, mesh tape is used for the sling under the urethra and held in place by the patient’s body rather than stitches. The sling is inserted through an incision in the vagina.

TOT sling (transobturator tape sling). In this less invasive approach, the mesh is inserted through the vagina and positioned using tiny incisions in the groin.