Vaginal slings for stress urinary incontinence in women

This study looked at the long-term effectiveness of vaginal slings to treat women who have stress urinary incontinence. It concluded that the sling was still working 17 years after the procedure. 

Stress incontinence is urine leakage when there is pressure on the bladder. It is often observed when a patient coughs, sneezes, or exercises. Stress incontinence happens as a result of weak muscles around the bladder that hold urine in.

Urinary incontinence can be treated by pelvic floor exercises, drug therapy, pessaries (to support the walls of the bladder) or nerve stimulation. Surgery can also be an option when these treatments do not work.

Tension free vaginal (TVT) procedures are used for stress incontinence. Most stress incontinence problems are caused by bladder neck weakness. In TVT surgeons insert a 'sling' which then supports the bladder neck and stops urine leakage.

56 patients were included in the study. These patients had a vaginal sling 17 years previously. All of the women were diagnosed with stress urinary incontinence. All of the women had their surgeries performed by the same surgeon. Patients had a reproductive system exam and a urinary function exam. Patients also filled out a questionnaire on procedure satisfaction. Patients were assessed for urine leaks with a cough test. Patients also reported urine leaks when they were coughing, sneezing or lifting a weighted object.

The sling was still effective in the majority of patients. Approximately 13% of patients suffered from urine leaks again. Two patients suffered a recurring urinary tract infection Two patients had surgery to correct a protruding rectum or bladder in the vaginal wall. Approximately 18% of patients had difficulty in emptying their bladder. 

This study concluded that the sling was still effective 17 years after it was implanted. 

The authors note that only one questionnaire used in the study was validated. This may affect the study's results. 

If you are interested in learning more about vaginal slings for stress urinary incontinence, contact your doctor.