Urologists at Urology Associates perform many types of self-fixating slings as an outpatient in properly selected patients. Self-fixating slings treat female stress urinary incontinence by placing a narrow strip of mesh in your body to support the urethra. The supportive mesh can often be placed utilizing a transobturator approach thereby avoiding your abdominal cavity. With this approach, narrow mesh carriers are passed through an area near the groin to an area underneath the urethra. The mesh is then attached and pulled into place.

Once placed, this sub-urethral hammock cradles the urethra and gives it a point of support.

Most patients are continent immediately following the procedure and can resume normal, non-strenuous activities within a few days.

Benefits

• Patients generally recover quickly and experience immediate continence.
  
• It is minimally invasive and suitable for a wide variety of patients.
  
• It is an out-patient procedure.
  
• Incisions in the groin area are small.
  
• Can be used in patients who have abdominal scarring resulting from prior pelvic surgery.

Technique

This procedure helps to correct the conditions that cause stress urinary incontinence by surgically placing a narrow strip of soft, polypropylene mesh in your body to cradle your urethra and give it a point of support. The self-fixating mesh anchors itself to your tissue and muscle in the space surrounding the urethra.

Placement of the sling is a minimally invasive procedure that often lasts less than 30 minutes under local, regional or general anesthesia, depending on what you and your doctor choose.

In general, the self-fixation sling technique involves the following steps. (Your doctor's method may vary slightly from this one.)

1. Two small incisions are made near the groin at the obturator of the pubic bone and one in the vagina.
   
2. Narrow sling carriers are passed through the groin incisions and exit through the vaginal incision.
   
3. The mesh is attached to the sling carriers, and placed under the urethra.
   
4. Sling carriers are removed.
   
5. Mesh tension is adjusted.
   
6. Incision is closed.

What to Expect After the Procedure

Your doctor may insert a catheter through your urethra to drain urine from your bladder immediately after surgery. The catheter may be removed either before or shortly after you leave the hospital.

Most women see results as soon as the catheter is removed.

Although many women have little or no pain after the procedure, your doctor may prescribe pain medication for you if needed and antibiotics.

Your incisions will be small and should heal quickly. For approximately four to six weeks you should avoid sexual intercourse, heavy lifting and exercise. You can return to other normal daily activities at your doctor's discretion, often within one to two weeks.

Your doctor will provide you with additional information on how to care for yourself after surgery, including any other limitations to activities.