Description:
Stress urinary incontinence is the involuntary leakage of urine during exercise or certain movements such as coughing, sneezing and laughing. It is usually due to weak or damaged muscles in the pelvic floor or sphincter.
Conservative treatments include pelvic floor muscle training, electrical stimulation, biofeedback, and mechanical devices (urethral plugs and inserts). Surgery is usually used if conservative treatments fail. There are four main types of surgical intervention: colposuspension, insertion of a tension-free vaginal tape, traditional suburethral slings and injectable agents.
Sling procedures are performed partly through the vagina and partly through a small abdominal incision, usually under general anaesthesia. The sling may be made of a strip of tissue from the patient's own abdominal fascia, from human donor tissue or from animal tissue. A tunnel is created under the mid or proximal urethra, extending upwards through the endopelvic fascia on both sides towards the back of the rectus sheath. The sling of allograft or xenograft material is suspended from the rectus sheath or anterior abdominal wall by loose sutures, creating a supporting 'hammock' for the urethra. Bone screws may sometimes be used to hold the sutures in place and anchor the sling to the pubis.
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