What to Expect After Bladder Sling Surgery

Urinary incontinence is one of the most common issues for women to experience. In fact, around 46 percent of women suffer from stress-induced incontinence (SUI) — involuntary bladder leaks triggered by things like coughing, laughing and exercise — yet shame and embarrassment often keep discussion of this topic silent.

Here at Proof, we understand the difficulties that come with bladder leakage, and believe that incontinence is nothing to be ashamed about. Our bodies are complex, and deserve to be taken care of — no matter how personal the issue.

 For many women, non-surgical interventions like physical therapy and even pessary rings can be a great solution—especially when the issue is addressed early on. However, when left untreated, SUI can worsen and become unmanageable. In severe cases, surgery may be a viable option. 

Let’s take a look at the most common surgical intervention, and what to expect after bladder sling surgery.

What is bladder sling surgery?

When dealing with serious SUI, bladder sling surgery can greatly improve bladder leaks. This type of procedure is typically recommended for women who are done having children, as delivery can undo the effects of bladder sling surgery.

How is bladder sling surgery performed?

SUI is caused by a sagging bladder, or weak pelvic muscles. Bladder sling surgery helps prevent leakage by lifting and supporting the urethra and bladder neck with either a mesh or tissue sling.

What are the different types of sling surgery?

The two most common types of bladder slings are midurethral and traditional.

Midurethral: This sling is inserted during an outpatient procedure that only takes about 30 minutes. Typically, a strip of synthetic mesh is inserted through a single incision in your vagina, and cradles the urethra like a hammock. The procedure may also involve a retropubic method (or tension-free vaginal tape) in which two additional incisions are made near the pubic bone to secure the mesh. The transobturator method is another midurethral option in which small incisions are made in the vagina and the labia to secure your sling.

Traditional: A traditional, or conventional, bladder sling is inserted during an inpatient procedure, which means you will likely spend a night in the hospital afterward. Traditional bladder sling surgery may use synthetic mesh, or tissue from your own body (or donor tissue). With this method, one incision is made in your vagina and one in your belly, in order to connect the sling using tension under the bladder neck. Conventional bladder sling recovery can take longer and may involve more complications.

Is a bladder sling the same as mesh?

A transvaginal mesh procedure is entirely different from bladder sling surgery. While both may use synthetic mesh, transvaginal mesh is a high-risk surgery intended for pelvic organ prolapse. Production of mesh for this surgery was banned by the FDA in 2019, while bladder sling surgery remains a safe and viable option for SUI.

How successful is bladder sling surgery?

For many women, bladder sling surgery is highly effective at preventing bladder leaks. The National Institutes of Health reports that midurethral bladder sling surgery has shown to be up to 81 percent effective in women one year after the procedure.

What to Expect After Bladder Sling Surgery

Bladder sling surgery recovery looks different for everyone. With an outpatient bladder sling procedure, you may experience pain for just a few days or for several weeks post-op. Inpatient bladder sling surgery can take up to six weeks for full recovery.

How painful is bladder sling surgery? 

The actual procedure should be painless, since it will involve anesthesia. During bladder sling surgery recovery, you may feel pain at the incision site, as well as some internal abdominal cramping. Your physician should prescribe you with pain medication during those first few days or weeks, but if your pain is unmanageable, see your doctor right away.

How long do you stay in the hospital after bladder sling surgery?

With a midurethral bladder sling surgery, you should be able to return home the same day — just be sure to have someone available to drive you.

With a conventional sling, you will likely need to stay at the hospital overnight for observation, but can return home the following day. 

How long does recovery take after bladder sling surgery?

Minimally invasive bladder sling surgery usually involves just a week or two of recovery time, while traditional slings may take up to six weeks for recovery. Plan on taking it easy, managing pain and avoiding strenuous activity.

How much bleeding is normal after bladder sling surgery?

Aside from blood at the incision site, you may experience some vaginal bleeding for up to a week or two after surgery. This bleeding should be light or pinkish in color and minimal. If you experience significant bleeding, call your doctor right away.

What activities are restricted after bladder sling surgery?

It’s important to listen to your doctor’s advice on restrictions after bladder sling surgery in order to avoid complications. For example, running after bladder sling surgery is not recommended. Common things to avoid during the first two to six weeks include:

- Sexual intercourse
- Strenuous exercise
- Heavy lifting
- Use of tampons or menstrual cups
- Driving (ask your doctor when it’s safe to drive again)

Is it normal to leak after bladder sling surgery?

Mild leaking after bladder sling surgery may not be an issue, but if leaks continue, talk to your doctor right away. In general, you should experience far fewer leaks (or none at all), and may even have a harder time emptying your bladder for a week or two.

Does bladder sling surgery involve a catheter?

A catheter is typically only used after a conventional bladder sling surgery if you are unable to urinate. 

What are the side effects of a bladder sling?

While most patients experience few side effects, there are always risks involved with any surgery. If you experience bloating after bladder sling surgery, the placement may be off, and you should consult your doctor.

Other complications include prolonged abdominal pain, painful intercourse and urinary tract infection. There is also a small chance that the mesh material could begin to erode through your tissue or become exposed.

Do bladder slings need to be replaced?

If your bladder sling is placed improperly or shifts over time, it may need to be removed or replaced.

As with any operation, it’s important to weigh the pros and cons, and consult your doctor for advice. For many women, bladder sling surgery provides powerful relief to chronic stress-induced incontinence, and can be a safe, minimally invasive procedure.

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