Mid-Urethral Slings
For Urinary Incontinence A Successful Alternative
About half of all women experience stress incontinence — losing urine when they cough, laugh, sneeze or exercise — at some point in life. It’s a common problem in women of all ages, starting in their 20s. Many women tell us stress incontinence limits their ability to work out or enjoy an active social life.
Fortunately, there are many treatment options to consider. You owe it to yourself to talk to a urogynecologist, a doctor who is specially trained to treat pelvic floor disorders and bladder problems, who can partner with you to explain the various nonsurgical and surgical treatment options to find the right choice for you.
Many women find relief by simply adopting a few healthy habits, such giving up caffeine or artificial sweeteners that can irritate the bladder. Losing weight can help, too. Exercises that strengthen the pelvic floor can alleviate the problem for many women.
Minimally invasive sling
However, behavior modification doesn’t resolve the issue for everyone. For those patients, surgical intervention is a highly successful alternative. For more than 15 years the mid-urethral sling has revolutionized the treatment of stress incontinence. In a minimally invasive procedure a mesh sling is fashioned to support the urethra, (the tube that allows urine to pass out of the body). The mesh sling has an impressive success rate and good long-term outcomes. It is usually performed at an outpatient surgery center.
At the turn of the century, my colleagues and I began performing mid-urethral slings for stress incontinence. We have done many of these the procedures, which are generally highly successful and low risk, depending on the individual patient circumstances. Patients can take a few days or a couple of weeks off depending on the nature of their work.
Further, the risk of developing a mesh-related complication is low. Only about 1 or 2 percent of currently used slings have to be removed due to some form of complication. That means 98-99 percent of patients who have slings end up having no significant complications. Up to 95 percent of women get great results from their sling, and they are able to resume sports and exercise or enjoy a good laugh without worrying about incontinence.
In contrast, alternative surgeries for stress incontinence are either less successful in the long term or more invasive.
To sum it up, the mid-urethral mesh sling is minimally invasive and generally highly successful and low risk. That’s why the American Urogynecologic Society has adopted a clear position statement confirming that mid-urethral mesh slings are the procedure of choice for uncomplicated stress urinary incontinence. (If you would like to read the statement, you can find it online at http://www.augs.org/p/cm/ld/fid=599.)
This position statement applies to the mid-urethral mesh sling that is used for incontinence. This statement does not apply to mesh used to treat pelvic organ prolapse, which involves higher risks, warranting a warning issued by the Food and Drug Administration.
Unfortunately, fear of those risks has led many women to avoid mesh altogether, including the sling procedure, which can alleviate many of their symptoms.
Our advice to women who suffer from incontinence is to discuss all your options with your doctor. At the Christiana Care Center for Urogynecology and Pelvic Surgery, we will discuss a broad range of nonsurgical and surgical treatments with you in order to make the decision that is best for you. Together, we can explore whether the mesh sling is the right choice.
Christiana Hospital Medical Arts Pavilion 2 302-623-4055
4735 Ogletown-Stanton Road, Suite 1208, Newark, DE 19713
Christiana Care Center of Women’s Health 302-623-4055
3706 Kennett Pike, Greenville, DE 19807
Christiana Care Concord Health Center 610-361-1030
161 Wilmington-West Chester Pike, Chadds Ford, PA 19317
www.christianacare.org/urogynecology
call 302-623-4055 or visit www.christianacare.org/urogynecology
You will meet highly skilled and caring physicians who are the only urogynecologists in Delaware who have completed fellowships and are board-certified in female pelvic medicine and reconstructive surgery:
Babak Vakili, M.D., is the director of the Christiana Care Center for Urogynecology and Pelvic Surgery. Dr. Vakili completed his fellowship in female pelvic medicine and reconstructive Surgery at the Louisiana State University Health Science Center.
Emily K. Saks, M.D., MSCE, is a urogynecologist with the Christiana Care Center for Urogynecology and Pelvic Surgery. Dr. Saks completed her fellowship in female pelvic medicine and reconstructive surgery at the Hospital of the University of Pennsylvania.
Howard B. Goldstein, D.O., MPH, is a urogynecologist with the Christiana Care Center for Urogynecology and Pelvic Surgery. Dr. Goldstein completed his fellowship in female pelvic medicine and reconstructive surgery at Cooper University Hospital in Camden, New Jersey.
Matthew Fagan, M.D., MS, is a urogynecologist with the Christiana Care Center for Urogynecology and Pelvic Surgery. Dr. Fagan completed his fellowship in female pelvic medicine and reconstructive surgery at Greater Baltimore Medical Center/University of Maryland.
