Suburethral mesh or slings

What are suburethral slings?

Surgical mesh or sling is a medical product used to provide additional support to the pelvic floor when it is weakened. Most surgical meshes are made of highly porous synthetic material - usually polypropylene - or sometimes of the patient's own tissue (such as, for example, the fascia lata, a tensor muscle located in the upper and lateral thigh), both types of material are very well tolerated by the body.

Sling is the standard surgical treatment for stress urinary incontinence, which causes urine leakage when the patient coughs, sneezes, laughs, lifts weights or performs physical exercise. In the case of female incontinence, a history of uterine surgery and childbirth - especially if it has been prolonged or with instrumentation - are risk factors. Incontinence in men may appear after prostate surgery, generally in the treatment of prostate cancer.

The first step in the treatment of urinary incontinence is usually pelvic floor rehabilitation with the help of a rehabilitator or physiotherapist. However, when this is insufficient, surgery with slings or mesh is considered. In cases where leakage is very abundant, or when other surgeries have failed, it is necessary to place adjustable meshes or even an artificial urinary sphincter.

In the case of women, the mesh or sling is placed under the urethra through a small incision inside the vagina. It is a simple and very minimally invasive procedure that lasts approximately 25 minutes. It is usually performed under short-term anesthesia and can sometimes be performed without hospitalization.

After surgery, patients remain with a catheter for a few hours and it is recommended to avoid heavy exertion during the first month after surgery to ensure adequate healing. Incontinence disappears as soon as the mesh is in place.

In the case of the male, the incision to place the mesh is usually made in the skin, below the testicles. It is also possible to place adjustable devices to regulate the pressure on the urethra. Once the surgical procedure is completed, the patient is admitted to the hospital for 24 hours.