Women that experience occasional leaks when they’re lifting, laughing, coughing, running, or putting any kind of pressure on the bladder may be suffering from Stress Urinary Incontinence or SUI. This is caused by the weakening of the pelvic floor muscles that support and regulate the flow of urine. These muscles can be weakened due to a number of things - childbirth, surgery, aging, and years of high impact activity are all contributing factors. One solution that some women may turn to is surgery to help repair and strengthen the weakened muscle control that is causing leaks.
Kinds of Sling Procedures
To understand the pros and cons of going through pelvic mesh surgery, it is important to distinguish between the two types of procedures women can get. The first kind is called mid-urethral sling surgery. This is when a thin strip of mesh (usually synthetic) is used to make the sling and is surgically placed under the urethra by one of three methods.
Retropubic method: A small cut is made under the urethra, in addition to two cuts being made above the pubic bone. A needle is used to put a sling under the urethra behind the pubic bone to support the bladder and urethra.
Transobturator method: A cut is made under the urethra and on each side of the labia. The sling is then placed under the urethra.
Single-incision mini method: A single cut is made in the vagina and the sling is put through it.
The second kind is called traditional sling surgery. A strip of tissue from the stomach or thigh (or from a donor) is taken to make the sling. Two incisions are made in the vagina and abdomen, and the sling is inserted through the cut in the stomach and is stitched inside the stomach wall.
There are benefits to getting the surgery, the most obvious being that the occasional leaks would lessen or stop completely. Another benefit is that depending on the procedure performed, the surgery and recovery time can be relatively short. Mid-urethral surgery is an outpatient procedure that can be done in 30 minutes and patients can go home that day, while traditional sling surgery requires a longer recovery time. Surgery might be the right option for you if you’ve exhausted all others and you’re still experiencing leaks or if the leaks are heavy.
Risks and Complications
With every surgical procedure there comes risks and complications. This is true for surgery to help stop leaks, as well. There are cons to take into consideration when potentially opting for surgery, but these are not meant to completely deter you from considering it as an option. Cost: The cost of choosing surgery to correct leaks associated with SUI can be expensive, ranging from $13,000 to $36,000. Health insurance coverage is a must. Infection: Especially with the use of synthetic mesh, infections can occur. This can be internal or at the incision sites. The after effects of infection can warrant medication or topical ointments, further adding to costs. Injuries: Injury to the bowel, bladder, nerves, or blood vessels can occur during surgery. Again, this may lead to further medical costs and complications. Further Urinary Complications: Some women may experience complications with urinating after surgery, while others may start to experience urge incontinence. Ultimately, choosing surgery is a decision that should only be made after discussion with your doctor regarding what is best for your body and lifestyle. It is important to note that as of April 2019, the FDA ordered certain manufacturers to stop the sale and distribution of their products for safety reasons.
Surgery is an option for women suffering from SUI, but it is a serious one. There are costs and risks involved that should be carefully considered. Pelvic floor muscle exercises and the use of incontinence products are another solution to leaks that are much more accessible to women. Some products like pads and liners simply cover up the leaks by absorbing them. Other products are reusable like Revive™, a device for women to help stop leaks from SUI. It can be purchased over the counter and inserted at home to wear comfortably for 12 hours. It prevents leaks instead of covering them up and is safe to reuse. Revive is giving safer and less invasive solutions to women with SUI.