The bladder sling is a surgical treatment option that can provide relief of symptoms. One type of sling is a pubavaginal sling and is made out of the patient’s own tissue, which is used to securely hold the bladder neck. Side effects include infection, accidental injury to the bladder, and urinary retention. Another type of sling is the transvaginal sling, in which the bladder is held upright by two tacks attached to the pubic bone. Unlike the pubavaginal sling, no abdominal incision is necessary for the transvaginal sling.
One of the most recent advancements in surgical options for the treatment of stress urinary incontinence is the development of the transvaginal Tension-Free Vaginal Tape (TVT) and Transobturator Tape (TOT) procedures. In both procedures, a narrow strip of artificial mesh is passed under the urethra through a very small vaginal incision using special inserters. These procedures are more than 90% successful in treating urinary incontinence and the results are immediate. Patients are usually discharged home without a catheter within one to two hours and with little or no pain.
Unlike other procedures performed for urinary incontinence, The TOT technique avoids entering the retropubic space. This is particularly advantageous for patients who have had previous pelvic operations including previously failed sling surgeries.