DR. MAYANK MOHAN AGARWAL
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Pubovaginal Sling Surgery

To help treat stress urinary incontinence (SUI), your surgeon may procedure a procedure called pubovaginal sling surgery. A “sling” of tissue or mesh will be placed like a hammock under the bladder and urethra. The sling helps to support the bladder and urethra firmly in place. This helps keep the urethra closed to avoid urine leakage. Your surgery will take about 2 hour(s). You will be asked to do some things at home to prepare for surgery.

How must I prepare for surgery?

The weeks before surgery

  • Have any tests that your doctor orders.
  • Tell your doctor about aspirin and other medicines, vitamins, or herbs you take. Ask if you should stop taking them prior to surgery.
  • Stop smoking to help reduce your risks during surgery.
  • If you have been given any prescriptions to fill, do this before surgery.

The night before surgery

  • You may be asked to give yourself an enemia. This will help to clean out your bowels for surgery. You’ll be told how to do it.
  • Follow any directions you are given for taking medicines and for not eating or drinking before surgery.

The day of surgery

As soon as you arrive at the hospital a few hours before surgery as directed. At the hospital, your temperature and blood pressure will be taken. In some cases, tests may be done. Then, you will receive one or more IV (intravenous) lines. These lines give you fluids and medicines before, during, and after surgery. Some of your pubic hair will be removed. Tight stockings (compression stockings) may be put on your legs to help prevent blood clots.

About anesthesia

You’ll receive anesthesia to keep you pain-free during surgery. General anesthesia enables you to sleep. Regional anesthesia numbs the lower part of your body. Local anesthesia numbs the area that will be operated on. Before the surgery, you’ll meet with the anesthesiologist or nurse anesthetist. He or she can tell you what kind of anesthesia you will be given and answer questions you may have.

What happens during the procedure?

  • An incision 2 to 4 inches long will be made in the lower part of your belly (abdomen), near the pubic hairline. A second small cut is made in the front wall of the vagina.
  • If tissue from your body is used for the sling, it can be taken from your abdomen or thigh. If synthetic material or donor tissue is used, it is cut to the right size.
  • Working through both incisions, usually 2 lateral cuts right above the pubic hairline, the surgeon will place the sling under the bladder and urethra. The ends of the sling are secured to strong tissues in the abdomen.
  • The incision in the abdomen is closed with sutures (stitches), staples, skin glue, or strips of tape (Steri-Strips). The vaginal incision is closed with sutures. Once this incision has healed, it should not cause you problems during sex.