Incontinence Treatment >>
Pubovaginal Sling Procedure
A sling procedure is done to create support where the urethra connects to the bladder (a.k.a. bladder neck). A sling is especially effective for the woman who has the diagnosis of Intrinsic Sphincter Deficiency (ISD) where the sphincter muscle is ineffective at holding urine in the bladder during certain "stressful" activities such as coughing, sneezing or exercising. There are many different types of "sling" operations described in the literature. The slings differ in the type of material, sutures, and points of anchoring. The decision on the type of sling utilized is surgeon dependent. The sling is placed under the bladder neck and is secured to a point of attachment (bone, abdominal wall, and ligament) through a vaginal incision. Therefore, when the woman coughs or sneezes, the bladder does not have as much motion now that the "backboard" is in place and so she will not experience any leakage. This procedure is done in the operating room under anesthesia and the patient goes home either the same day or the following day. The most recent efficacy statistics for patients undergoing pubovaginal sling procedures is upwards of approximately 85% for patients who have had the surgery 10 years ago. A sling procedure is considered "curative" for the female patient.
Tension-Free Vaginal Tape (TVT sling) Sling
Drs. Miklos and Moore have been trained to perform a number of different types of sling operations utilizing various types of material, sutures and points of anchoring. Currently they choose to offer their patients an extremely minimally invasive sling operation known as the TVT sling or tension free vaginal tape sling.
Dr. Miklos learned the tvt sling procedure in Stockholm, Sweden in 1998. This type of tvt sling procedure has been performed in Europe for more than 6 years with great success. Dr. Miklos was the first surgeon in the Southeastern United States to perform the tvt sling operation and serves as a preceptor to teach this operation to Urologists, Urogynecologists and Gynecologists throughout the world. In June 2000, Dr. Miklos traveled to Russia to introduce the TVT sling operation to his colleagues at the University of Moscow.
Both Drs. Miklos and Moore choose the TVT sling for their patients because the operation is/has:
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Minimally invasive (two incisions of 1/3 inch on the pubic hairline) |
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Minimal pain (40% of patients will not need a pain reliever after 24 hours) |
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Proven cure rate of 86% |
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Same day or next day discharge for 98% of patients |
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Performed under local anesthesia and IV sedation |
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Operative time 20-30 minutes |
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Minimal postoperative need for catheterization |
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Minimal complications |
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