What it is
This is for leaking that happens when pressure goes up. Coughing, sneezing, laughing, lifting, running.
A narrow strip of mesh goes under the urethra, through a small cut inside the vagina. It sits there like a hammock and catches the urethra when pressure spikes.
It does not help the other kind of leaking, the sudden urge you cannot hold. Working out which one you have comes first.
Why it is done
- Leaking when you cough, sneeze or laugh
- Leaking at the gym, or lifting a child
- Wearing a pad every day for it
- Pelvic floor therapy tried and not enough
- Leaking that started after a birth, or got worse after menopause
- Leaking that shows up once a prolapse is pushed back into place
What happens, step by step
- 1
History and exam
Dr. Mueller asks when it happens and checks it on exam with a full bladder.
- 2
Bladder testing
A urine test rules out infection. A bladder study can separate stress leaking from urge.
- 3
The operation
One small cut inside the vagina, two tiny ones outside, and the sling passes under the urethra.
- 4
Tension check
The sling is left loose enough that you can still empty your bladder.
- 5
Home the same day
You leave once you have urinated on your own.
- 6
Follow-up visit
Seen at two weeks, with nothing in the vagina and no lifting for six.
Questions people ask
- Is this the mesh that was recalled?
- No. The 2019 FDA action was on mesh placed through the vagina for prolapse. The sling used for leaking was not part of it.
- Does it work?
- The sling has been studied for decades. Dr. Mueller will go through the published results and the risks before you decide.
- Can I still have a baby afterward?
- You can, but a pregnancy can undo it. If you are not finished having children, it is usually worth waiting.
- What if I still leak after?
- Tell Dr. Mueller. Some of it is the other type of leaking, which needs medication or pelvic floor therapy instead.
- Will I be able to pee normally?
- That is checked before you leave. A small number of women are slow at first and need a catheter for a few days.