Sling Surgery For Prolapse: Risks, Benefits And Other Treatment Options?
Many women experience prolapse in their lifetime. Prolapse is when the pelvic organs are no longer supported by the pelvis and fall out of place, which can cause bladder incontinence, fecal incontinence, or sexual dysfunction.
Sling surgery is a surgical procedure that helps support these organs to keep them in place. This blog will discuss what sling surgery entails and who can receive it.
Sling surgery for prolapse: What you need to know before considering this surgical option!
What is prolapse?
If the pelvic organs are not supported by muscles, connective tissue, or ligaments, they can begin to slip out of place.
This condition typically occurs in women after menopause when the hormone balance has changed, but it can also occur in young women who have given birth several times.
High impact activities such as jumping, coughing, or playing sports can also cause pelvic organ prolapse.
The most common type of pelvic organ prolapse is uterine prolapse, where the uterus slips into the vagina.
Other types of pelvic organ prolapse include:
- Bladder or urethra falling into the opening of the vagina
- Rectum falling into the vagina
- Vaginal bulge caused by falling of pelvic floor muscles and structures
What is a sling?
A sling is a strip of material, like an elastic band, that supports the pelvic organs to keep them in place. A common type of sling surgery uses your body’s own tissue; we call this a biological graft or autograft.
How does sling surgery work?
A woman who has pelvic organ prolapse may be a candidate for sling surgery.
During the procedure, the doctor makes an incision in the vagina to see where the problem areas are.
The doctor then pulls up the vaginal lining and supportive structures through this incision.
The doctor then places a piece of graft material over these structures to support them while they heal.
The doctor then makes another incision in the lower abdomen to access the inside of your pelvis and create a tunnel into your vagina where the graft material can be anchored.
The doctor then threads the graft material through this tunnel into the vaginal space, where it is then secured in place with stitches, clips, or both. After reinforcing the area with the graft material, the doctor closes up the incisions.
What are the benefits of sling surgery?
The most common benefit is that it can treat stress urinary incontinence (SUI) in some women by preventing urine leakage when they laugh, cough, or sneeze. However, some women experience improvement of their symptoms but still leak urine, even after sling surgery. Other benefits of this surgery for women include:
- Improved ability to control bowel movements
- The restoration of compliance and support for organs
- Relief from backache and pelvic pain
Who is a good candidate for surgical treatment?
Not every woman with uterine prolapse or pelvic organ prolapse is a good candidate for sling surgery. During your pelvic health physical exam, your doctor can help determine if you are likely to benefit from this surgical procedure.
Sling surgery does not fix the cause of prolapse; it simply supports the organs back into place until they can heal.
At first, the vagina will be swollen and painful after surgery and you may not be able to perform your daily activities.
It is important to be aware of this and work with your doctor on a post-operative plan so that you can heal quickly and get back into your activities as soon as possible.
Sling surgery can also help treat stress urinary incontinence (SUI) in some women, which is a common symptom of pelvic organ prolapse.
If you have symptoms like these and your doctor recommends surgery, it is important to ask about other options such as urethral inserts or bladder training first because sling surgery doesn’t treat all types of SUI!
Sling surgery carries some risks , including:
- Infection from the incisions or graft material
- Bleeding or other complications during surgery
- Recurrence of prolapse; this is more likely if the reason for the prolapse has not been fixed (for instance, if you were obese before your surgery)
What are other treatment options?
If sling surgery doesn’t make sense for you, then there are still many things you can do to help manage your symptoms!
– Kegel exercises: these are excellent pelvic floor strengthening exercises that can help strengthen the muscles around your vagina and bladder so they function better.
Click here for more information on kegel exercises!
- Lifestyle modifications: making changes to how you live every day, like increasing exercise and losing weight, can have a huge impact on both the severity of your prolapse and how you feel.
- Medication: there are a number of prescription drugs available to support pelvic organ prolapse.
- Surgery: other surgeries that may be an option for you include a pessary, colposuspension, or sacral colpopexy.
A pessary is a device worn inside the vagina to provide support. It is usually made of silicone or plastic and is available in different shapes, sizes, and textures.
A sacral colpopexy (also called posterior colporrhaphy) uses stitches or other implants under the bladder tissue to attach it more firmly onto the back wall of the pelvis.
Although all these surgeries carry some risks, modern methods and advances in surgical techniques can make them very safe.
What should I ask my doctor about sling surgery?
If your doctor recommends this surgery for you, make sure that you are receiving care from a gynecologist or colorectal surgeon who specializes in pelvic health. Not all doctors are trained to treat the full range of pelvic floor conditions.
If you are interested in sling surgery, be sure to ask your doctor about:
- What makes them qualified to do this kind of surgery (i.e., do they have specific training or experience? Have they had patients like me before?)
- How many surgeries they’ve done of this type
- The risks and complications associated with surgery
- What improvement I am likely to see after surgery, including how long it will take for relief of symptoms
