By the time women are ready for incontinence treatment, they’ve been dealing with incontinence for years. The physical, emotional, social, and even sexual effects have taken their toll. Women become tired and frustrated, and when they finally decide to take action, they want immediate results. So, after doing their millionth Kegel, the only treatment that seems to have the potential to deliver results is bladder sling surgery.
Bladder sling surgery, also known as vaginal sling surgery or urethral sling surgery, is widely used to treat severe stress urinary incontinence (SUI). The procedure often involves implanting a piece of plastic mesh below your urethra or bladder neck to provide extra support. Surgeons insert the device through an incision in your vagina. Think of the mesh as a kind of hammock that the surgeon needs to adjust to the correct tension to provide the necessary support. When you sneeze, exercise, or cough, the mesh should reinforce the bladder to eliminate leaks during these sudden moments of pressure.
Recovering from bladder sling surgery takes several weeks. Because of the vaginal incision, doctors usually recommend no tampons or sex for up to 6 weeks. There also are limitations on working out and lifting heavy weights so the sling doesn’t get moved out of place. After weeks of recovery, you can resume full activity and ideally should be in total control of your bladder. Success rates vary, but one meta-analysis of surgery reported an 82% success rate.
There are known risks associated with the mesh implants used in sling surgery. One of the main concerns is that pelvic meshes can break into fragments that embed into your tissue, become dislodged, and potentially perforate neighboring organs. When this happens, not only does the incontinence continue, but women experience intense pain and discomfort, often ending up worse than before the surgery. These complications frequently require follow-up surgeries to fix the mesh or even remove the device entirely.
In 2019, the FDA ordered a halt to the sale of transvaginal surgical mesh implants for certain pelvic procedures, and in many countries, pelvic meshes have been outlawed completely. Recently, in-depth media coverage and large class-action lawsuits have shed light on the dangers of bladder sling surgery. However, many women don’t know about the alternative, nonsurgical treatment options.
In addition to health risks, sling surgery is a costly option for leaky bladders. The price tag can range from 6,000 to 25,000USD. And even after surgery, women still spend on average $190 a year to manage residual leaks, spending money on pads, laundry, and dry cleaning. For those women who need a second surgery to remedy a bad first outcome, the total cost can quickly rise to 50,000USD for surgical removal of a failed implant.
On the flip side, electing not to pursue any treatment is expensive, as well. The same study referenced above found that women spend on average $750 per year managing their incontinence symptoms.
In the study that investigated surgical success rates, the second most effective treatment was pelvic floor exercises. You’ve probably heard this advice before, particularly after childbirth: “Do your Kegels.” Although pelvic floor exercises have been proven to be effective for SUI, many women don’t do Kegels correctly or consistently enough to notice a difference. In order to better support the bladder, you must regularly contract the relevant muscles in order to strengthen the pelvic floor. But it’s difficult to remember to do Kegels or even to know whether you’re squeezing the right muscles.
So what are the alternatives? Several conservative treatment options are available for you to consider before surgery, including devices that actually perform Kegels for you.
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