The vaginal sling procedure is also called the pubovaginal sling procedure. It’s a type of surgery used to treat urinary incontinence in women.

Urinary incontinence is the medical term for the inability to control your bladder. This condition leads to the leakage of urine. For example, you may experience urine leakage after coughing or sneezing. Or you may experience strong and sudden urges to urinate, which lead to urine leakage when you can’t make it to a toilet in time. If you have severe urinary incontinence that affects your daily life, your doctor may recommend a vaginal sling procedure to treat it.

When you urinate, a circular-shaped muscle around your bladder relaxes and releases urine into your urethra. Your urethra is the tube that leads from your bladder to the outside of your body. In the vaginal sling procedure, your surgeon will use a piece of tissue or synthetic material to make a sling around your urethra. This will help keep your urethra closed and prevent urine leakage.

The vaginal sling procedure is one treatment option for stress urinary incontinence in women. Depending on how severe your urinary incontinence is, your doctor may prescribe other treatment options first. If those treatments don’t work, your doctor may recommend the vaginal sling procedure. They may also recommend this procedure if you have a severe case of urinary incontinence and your bladder problems disrupt your everyday life.

The two main types of vaginal slings are conventional slings and tension-free slings.

Conventional slings

Conventional slings are made from one of the following:

  • synthetic material
  • animal tissue
  • tissue from your body
  • tissue from a deceased person’s body

Your doctor will place this tissue or synthetic material around your urethra and fasten it with stitches.

Tension-free slings

Tension-free slings or vaginal tapes are usually made of mesh. Your doctor will place this material around your urethra. Instead of using stitches to secure it, they’ll use the surrounding tissues in your body to keep it in place.

Any time you have surgery or an opening is made in your skin, risks are involved. These risks include:

  • bleeding
  • blood clots
  • breathing problems
  • infections

The vaginal sling procedure also involves other specific risks, including:

  • injury to or irritation around your vagina, bladder, or urethra
  • other changes in your vagina, such as a dropped or prolapsed vagina
  • development of a fistula, which is an abnormal connection or tunnel between your skin and vagina
  • overactive bladder or problems emptying your bladder

Over time, the material used to create the sling can break down and create other health issues. If you’re an older adult and you’ve already gone through menopause, your doctor may advise you to avoid the vaginal sling procedure.

Before you have a vaginal sling procedure, tell your surgeon about any medications you’re taking. Your surgeon may ask you to stop taking certain medications a few days or hours before your surgery, including medications that thin your blood, such as warfarin, aspirin, and ibuprofen. They may also ask you to avoid eating or drinking anything for six to 12 hours before your surgery.

Be sure to dress in comfortable clothing and arrange for a ride home.

Before your surgery begins, you’ll undergo general anesthesia or spinal anesthesia to prevent pain during the procedure. Your healthcare team will likely insert a catheter, or tube, into your bladder to drain your urine.

During the procedure, your surgeon will make a small incision inside of your vagina. They may also make an additional incision in your abdomen, above your pubic bone, or on each side of your labia. They’ll insert the sling, which is a strip of tissue or synthetic material, through your incisions. Then, they’ll secure the sling around your urethra, with or without stitches.

The vaginal sling procedure is usually performed on an outpatient basis. That means you’ll probably leave the hospital after your surgery to recover at home. In some cases, you may need to stay in the hospital for one to two nights afterward.

Most people fully recover from this procedure within one to three months. It’s important to follow any discharge and care instructions that you receive after surgery. Your doctor will probably schedule a few follow-up appointments with you. Be sure to keep those appointments and talk to your doctor about any complications you might experience after your surgery.