Pubovaginal Sling
Pubovaginal Sling Procedure by Jeffrey P. Norris, M.D. Originally appeared in Urology Update, the patient newsletter of Northwest Suburban Urologists, LTD. The pubovaginal sling procedure is a well-tolerated minimally invasive surgical procedure that is performed for treatment of stress urinary incontinence. This is done through a small vaginal incision. Tiny titanium screws are placed in the pelvic bone on both the sides of the urethra. These screws are attached to sutures that support a rectangular strip of durable tissue that is passed beneath the urethra. This rectangular patch supports the urethra and the bladder, so that the leakage does not occur during coughing, sneezing, laughing or other physical activities. The patients typically do not require more than one day of hospitalization and sometimes can go home on the same day. Many times, this procedure will be performed in conjunction with cystocele repair surgery. A cystocele is a name for a dropped bladder, and this can be repaired by pulling the pelvic muscles together, so that the bladder can no longer drop and cause bulging or pressure through the vagina. As with any surgery, there are potential risks but they occur infrequently. Your surgeon should discuss these risks with you prior to surgery. You should also be aware that following sling surgery and prolapse repair, it is not uncommon to have symptoms of double voiding, slow urinary stream, frequent urination and sense of urinary urgency. When these symptoms occur they often improve with time, but may need to be treated with medicine, behavioral/exercise therapy or even a minor revision surgery. It is important to have realistic expectations when considering surgery for stress urinary incontinence and vaginal prolapse. As surgeons, our goal is to improve bladder control and pelvic health. It is usually not possible to restore a patient’s condition to the way it was before there was ever a problem. In conclusion, the pubovaginal sling procedure and cystocele repair surgery are typically well-tolerated minimally invasive surgical procedures that effectively treat female stress urinary incontinence and pelvic floor prolapse.
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* 출처: http://www.northwestsuburbanurologists.com/articles/pubo.pdf