This procedure is to treat stress urinary incontinence. This may either be a retropubic sling or a trans obturator sling
Assessing why you leak urine
To determine your pattern of frequency, urgency, night visits to the toilet to pass urine and to evaluate why you are leaking urine involuntarily, it is always a good idea to assess how much fluid you are consuming, what type of fluids you are drinking (water, coffee, tea or alcohol), how much urine you are passing and whether youd could make it to the toilet without an accident. You can acheive this by doing a Bladder Diary. A bladder diary is an important tool not only for your clinician to make this assesment, but for patients to self assess what their oral intake pattern is like. You may be asked to complete a three-day bladder diary before coming for your follow up visit.
What is a Mid Urethral Sling Procedure (MUS)?
The procedure is mainly performed under a short general anaesthesia to treat stress urinary incontinence. Local or spinal anaesthesia may be used if required.
Two different approaches can be used – a sling that is retropubic, or passes behind your pubic bone, or a trans-obturator sling (the sling passes from the groin region just adjacent to the groin crease. A very small incision is made in the vagina, just under the urethra for the placement of tape in both approaches.
The procedure lasts about half an hour. A camera in inserted at the end of the procedure (cystoscope) to exclude any bladder injury during the operation. You will be admitted overnight and a trial of void done to ensure you are able to pass urine without any issues (i.e difficulty in initiating the passage of urine or any incomplete voiding of urine). In the event there has been an inadvertent bladder injury, you may be asked to stay a few more days.
Prior to having this procedure done, you may be asked to have Urodynamics. We will arrange a referral to our Urology colleagues to have this done for you. Having urodynamics helps us chose the most appropriate treatment for your incontinence. Some patients may not need surgery and instead can be managed conservatively with physiotherapy and medications.
Read the RANZCOG positional statement regarding mid uretheral slings here.
Post Operative Instructions
There may be some vaginal discharge up to 4 weeks which can be blood stained. This should be light bleeding or spotting only, and this may vary as healing occurs and your stitches dissolve. If you are concerned that the discharge is increasing, becoming foul smelling or if you have a fever or pain despite taking pain killers, please call us immediately. If you cannot pass urine and need to strain, please visit the Emergency Department at LGH immediately or call us during office hours Monday to Thursday between 9 am and 4.30 pm.
For more information on recovering from your procedure, click here.
You may be asked to take antibiotics and anti inflammatory medications like Nurofen for 5 days - please check with your treating surgeon. A follow up appointment will be made around 10-14 days after the procedure to ensure you have no issues passing urine. A further post operative internal check will be done at your 6-8 week visit at the Rooms. Please remember to have plenty of oral fluids and pass urine regularly. Avoid intercourse, swimming, the use of tampons and any cosmetics to the area until you have attended your follow up visit.
It is important to stop smoking, lose weight if you are overweight and regularly do your pelvic floor exercises to have the best outcome of your surgery.