A midurethral sling system is designed to provide added support for the urethra. This is especially helpful in controlling symptoms during physical activity. A synthetic mesh strap is placed under the urethra using a minimally invasive technique.
There are two main types of midurethral sling procedures: retropubic and transobturator. The retropubic technique is the first procedure introduced to treat stress urinary incontinence and is commonly referred to as TVT (tension-free vaginal tape). Your surgeon will place a thin piece of soft, flexible mesh through a tiny incision in the abdomen and vagina to support the urethra. This mesh acts like a supportive sling allowing the urethra to stay closed preventing urine leakage. Transobturator (TOT) was developed to minimize the potential for bladder injuries since it avoids surgical movements between the pubic bone and the bladder. TOT is a minimally invasive procedure that involves the placement of a small piece of polypropylene mesh around the pubic bones underneath the urethra.
TOT and TVT are both types of slings made of polypropylene mesh, which stay in place without stitches. You and your surgeon will discuss what surgical option would best suit your needs.
Urethral slings are done in the operating room under general anesthesia and can be done through an incision in the abdomen, through the vagina, or with laparoscopy.