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

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