The bladder acts as a storage tank, ideally holding urine until there is a convenient time and place to urinate. Many people suffer embarrassment and discomfort due to urinary incontinence--loss of bladder control--particularly as they age. In some cases, a doctor might recommend treating urinary incontinence with surgery to install a bladder sling. The sling cradles either the bladder or its emptying tube, the urethra, to help keep the urethra closed and avoid involuntary loss of urine, according to MayoClinic.com.
Traditional Sling
A traditional bladder sling treats incontinence in women whose bladders have moved out of the correct position, often due to childbirth. According to the National Institute of Diabetes and Digestive and Kidney Disorders, after making an incision through the vagina, the surgeon attaches a piece a material to the narrow neck of the bladder. The material can be a type of connective tissue called fascia, either from the patient or a donor, or it can be a special synthetic material. The surgeon attaches the ends of the material to the pubic bone or ties them together to create a supportive framework for the bladder.
Mid-Urethral Sling
As described by the National Institute of Diabetes and Digestive and Kidney Disorders, in this newer procedure, the surgeon creates a support for the urethra rather than supporting the bladder itself. The surgeon attaches a man-made mesh material about halfway down the urethra. Mid-urethral slings can be fashioned using a "retropubic" approach, going into the space behind the pubic bone, or a "transobturator" approach, avoiding the delicate connective tissue and blood vessels behind the pubic bone. The retropubic approach is also called a transvaginal tape or TVT procedure, while the transobturator approach also goes by the acronym TOT. In either case, in addition to a small incision through the vagina, the surgeon makes small incisions in the groin to guide insertion. With the mid-urethral sling procedure, patients can avoid a stay in the hospital because surgeons can perform the operation on an out-patient basis.
Male Sling
Although urinary incontinence affects women twice as often as men, according to the National Institute of Diabetes and Digestive and Kidney Disorders, a significant number of men also suffer from this condition. Like the mid-urethral female slings, the "male sling" treats incontinence by supporting the urethra instead of the bladder. The surgeon wraps supportive material around the urethra and attaches each end to the pelvic bone. The sling presses on the urethra so urine passes only when the patient makes a conscious effort to urinate.
