Bladder slings, medically referred to as Midurethral slings, according to an article on the Memorial Healthcare System, are utilized as a surgically invasive procedure designed to medically correct a medical condition known as “stress incontinence.” Stress incontinence is the fancy name for loss of bladder control when engaging in certain physical activities that can place stress upon the bladder or urethra. For example, women who suffer from this condition can often lose bladder control from performing simple functions like lifting heavy objects, exercising, bending and stretching, or even from involuntary functions like sneezing or laughing. Often, bladder slings are compared to, or even mistaken with, TransVaginal Mesh —but they are an entirely different type of surgical material and require a different and unique, but similar, surgery.
Bladder slings are the most common treatment for SUI. The slings are constructed of a plastic-like mesh material that’s hung around the urethra and bladder to help keep them closed.
Although there are several types of bladder slings, the most commonly used are tension-free vaginal tape (TVT) slings, transobturator tape (TOT) slings, and mini-slings. While these slings can help manage an overactive bladder, they’ve also been linked to serious health complications. Below, you’ll find information on each of the types of bladder slings and the health risks involved.
The tension-free vaginal tape sling is a mid-urethral sling that’s made from synthetic polypropylene mesh. The traditional TVT slings require a retropubic surgical procedure. The retropubic area is located between the pubic bone and bladder. Incisions are made below the urethra and above the pubic bone, so that the surgeon can pass a needle with the sling attached to it through the retropubic area. Since the surgeon will lose sight of the needle when it passes through the body, this procedure carries a high risk of urethral and bladder injury. After the surgery is complete, scar tissue will form around the mesh area to hold the sling in place.
Research has shown that bladder slings are generally safe to treat SUI. However, serious health risks like mesh erosion and organ perforation can occur. The plastic-like material of the sling can erode in the body and cause mesh fragments to become embedded in the nearby tissue. In addition, the sharp edges of the mesh fragments can puncture organs near the implant, causing internal bleeding and infection.
The Transobturator tape sling is another type of mid-urethral bladder sling. Compared to TVT slings, the surgical procedure for TOT slings has a lower risk of urethral and bladder injury. The same vaginal incisions are made in order to pass the needle through the body, but rather than going through the retropubic area, the sling enters the body by the labia. After the needle is passed through the labia, it’s threaded below the urethra. This method reduces the risk of bladder injuries because the needle bypasses the retropubic area. Just like with TVT slings, the scar tissue from the surgery holds the TOT bladder slings in place without additional stiches.
While there may be fewer surgical risks with TOT slings, mesh erosion, organ perforation, and difficulty urinating after surgery can still occur with these types of slings. For example, the Mentor ObTape, which is manufactured by Johnson & Johnson, has been pulled from the market due to the higher-than-normal rates of mesh erosion. In addition, injured patients have filed lawsuits against the manufacturer under product liability law. The lawsuits allege that the Mentor ObTape caused serious injuries like painful bloody discharge, infections, and punctured organs. If you’ve experienced any of these symptoms, you should talk to your doctor immediately.
Mini-slings are the newest type of bladder slings. Mini-slings are made of the same plastic-like mesh material as the TVT and TOT slings. However, the surgical procedure is less invasive than that of TVT slings, since it doesn’t require passing a needle through the retropubic area. Unlike the TVT and TOT slings, only one vaginal incision is required for the mini-sling. The mesh is then placed in a U-shaped formation in the mid-urethra and is held in place by scar tissue.
Mini-slings have only been used since 2006, so the long-term side effects are still being studied. However, recent research has shown that even though mini-slings result in fewer bladder injuries during surgery, they may not treat incontinence problems as well as other types of bladder slings.
A surgeon will perform the procedure by making a small incision in the vagina and above the pubic region. They will then use either special material – that is similar to mesh – or will use materials from your body (organic materials) to create a special sling that provides underlying support for the vagina, connected by the stronger soft tissues in your stomach. The goal of bladder slings is to reinforce a weak bladder and prevent stress incontinence from occurring.
There are some associated risks with bladder slings. It should be noted that no surgical procedure comes without associated risks.
If you are noticing persistent systems post-surgery, it could be due to defective products or negligence. Contact a qualified physician for a complete pelvic examination and any necessary tests or scans to gain effective diagnosis. Depending upon the diagnosis, you may have legal options for ramification, which can be addressed by qualified legal counsel.