Mid-Urethral Sling Retropubic
A Gold standard procedure for urinary stress incontinence. This procedure is performed under local or regional anaesthesia. Small incisions are made in the vagina and the permanent tape is introduced via the vagina to sit under the urethra. The trochars used to introduce the tape are removed through small incisions on the lower abdomen as shown. The advantage of performing this procedure under local or regional anaesthetic is the tape tension can be adjusted to control leakage while you cough. Success rates up to 10 years after surgery remain high at 85-90%.
Serious complications are rare with this type of surgery. However, no surgery is without risk and the main potential complications are listed below.
- 10 -15 % failure rate
- 1-5% voiding difficulties necessitating catheters after the surgery. Re-Operation to loosen or cut the tape occurs in 1%
- 5-10% bladder irritability after the surgery
- 1-5% urinary tract infections
- very small risk of damage to the bladder, urethra or blood vessels
- 1% risk of wound infection
- <1% risk of blood clots in the legs or chest
- 1-3% risk of tape erosion into vagina, bladder or urethra. Subsequent surgery may be required to correct
- <1% risk of pain or infection that may require removal of the tape
Hospitalisation and recovery
You will be admitted to hospital for 1-3 days depending on your bladder function after the surgery. You will have a catheter in the bladder after the surgery and this will be removed the next day. If other surgery is performed at the same time you will have a pack in the vagina for the first 24hrs. At home you will recover fairly quickly and will be able to return to light activities after 2 weeks. If you develop symptoms of a urinary tract infection (burning or stinging as you pass urine) you should see your local medical officer. You will see Dr Maher 6 weeks after your surgery.