Transobturator Sling Therapies and Surgery

Stress incontinence is a common condition that involves an involuntary loss of urine; it occurs when physical movement places pressure, or stress, on the bladder. Women with this condition may experience urine leakage while coughing, laughing or participating in physical activities. Stress incontinence often occurs as a result of weakened sphincter and pelvic muscles that cannot adequately support the bladder and/or urethra. If conservative treatment is unsuccessful, a transobturator sling procedure may be performed to support a weak pelvic floor and urethral sphincter muscles. During a transobturator sling procedure, a strip of synthetic mesh tape is used to create a sling under the urethra. The transobturator sling acts like a hammock; it supports the urethra and helps keep it closed, preventing urine from leaking out. The transobturator sling procedure is safe and effective, and has a lower risk of bowel and bladder injury than other sling procedures.

The transobturator sling procedure is performed while the patient is sedated under general anesthesia. Two small incisions are made on the inner thighs, on either side of the vaginal opening, and a small incision is made in the vagina. Surgical needles are inserted and used to to position a synthetic mesh tape under the urethra. The surgeon then adjusts the tightness or tension of the tape just enough to support the urethra. Patients can often return home the same day of the procedure, although they may experience some pain and discomfort, and vaginal bleeding may occur for a few days. Most patients regain bladder control, and have less urinary leakage, after undergoing the transobturator sling procedure.

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