Urethral Sling Procedures: What You Need to Know

Understanding Urethral Slings & Tape, from a Double Board Certified Pelvic PT

👋🏼 Hi, there! 👋🏼 Do you have questions on pelvic surgeries?  I can help!  It's me, Dr. Kelly, double board certified Pelvic Physio and YOUR go-to expert for all things pelvis and pelvic floor related!   Today, I want to dive into the nitty-gritty of urethral sling, or urethral tape, procedures.

In a nutshell, a urethral sling or tape is used to support the base of the bladder and/or urethra to help control leaks.  But the terminology can be confusing, so let's start there. 

Deciphering Urethral Sling Procedures 

What are Urethral Slings / Bladder Slings Made out of?

Urethral slings / bladder slings can be crafted from the patient's tissue (autologous), a cadaver donor (cadaveric), or surgical mesh.

Crucially, urethral slings or tape should support the urethra without crimping or kinking it too much.  If they are too tight, they can cause pain and difficulty peeing when you want to.  

While some amount of post-procedure discomfort is normal, excessive pain, or inability to pee is a red flag, so talk to your surgeon immediately, as in rare cases, the sling/tape does need to be loosened, and in those rare cases, the sooner the sling/tape is loosened, the better the outcomes.

Procedure Options

Transvaginal Sling/Tape (TVT): 

Involves small incisions made anterior to (in front of) the urethra (pee hole).  Incisions are in the lowest part of your belly, just under where your underpants would rest.

Transobturator Sling/Tape (TOT): 

Supports the bladder/urethra via small incisions underneath the vagina, near the upper thigh.

Potential Side Effects of Urethral Sling or Tape:

Local discomfort is a common but manageable occurrence.  Pain can be in the abdomen, low back, tailbone, or actual crotch and inner thigh region.  TOT has a higher incidence of upper/inner thigh pain, and TVT has higher incidence of lower abdominal pain...which makes sense because that's where the incisions are :)

Pelvic floor muscle hypertonicity may manifest and can be effectively treated with Pelvic Floor PT.  Remember that while EVERYONE needs post-operative Pelvic PT, pre-hab of the pelvic floor can be HUGE here in preparing your tissues for surgery!

In rare instances, compression of the urethra may necessitate adjustments to the tape, and it is important that this loosening is done in the first 10 days for optimal outcomes, so talk to your surgeon if you are having excessive pain or problems peeing.

Post-Procedure Care after Urethral Sling or Tape

Immediate consultation with the surgeon is imperative if difficulties with urination persist.

Pelvic Physiotherapy is important to address common post-procedure pelvic muscle hypertonicity, as well as to correct abnormal movement patterns that we may have developed due to our history of leaks.  Now is the perfect time to reconnect with your pelvis!

It’s YOUR BODY.  You DESERVE to know what’s going on!

Understanding the basics of urethral slings and tape empowers individuals to make informed decisions about their health. 

Whether you have undergone surgery or are contemplating it, recognizing the pivotal role pelvic floor PT can play in the recovery process is crucial, and 1-3 pre-procedure visits with a Pelvic PT (in person or online) are vital to optimizing outcomes. Here’s my scheduling site if you’d like to work with me, and here's a popular post on how to find a Pelvic PT near you.

For those seeking alternative avenues, perhaps we’re not ready to see a Pelvic PT in person, consider a high-quality online course from a trusted professional (like me!). Pelvic Floored offers world-class streamable pelvic wellness programs, that you can work through at your own speed, in the comfort and privacy of your own home, for a fraction of the cost of one:one Pelvic PT.  All Pelvic Floored courses are seamlessly streamable between your phone, computer or tablet (they keep your place), and are regularly updated with new evidence and client feedback!

A Surgical Prep and Post-Op Recovery Course is in the works, so be sure to sign up below for notifications for that (& other) courses!  Until then, Vag Lab is a 2 hour masterclass in vaginal and pelvic floor muscle health, and The Signature Series is a 12-week lifestyle and exercise revolution. Both courses have helped thousands prepare for, and recover from, pelvic problems, and I can't wait for YOU to be my next success story!

Thank you for delving into this essential information!

xoxo, Dr. Kelly 😊

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