What is the difference between sling and colpo-suspension?
1. In the Burch colposuspension, the front or anterior part of the vaginal wall is suspended at the level of the bladder neck with permanent stitches tied to muscle ligament to hold it in place.
2. In the sling procedure, a strip of muscle, ligament, or tendon, from an animal like a pig, or synthetic material or tissue taken from the woman is used.
This procedure involves placing a sling directly under the bladder neck or mid-urethral area to act as a physical support to prevent the bladder neck and urethral slipping or dropping during normal daily activity. The strip is attached to the abdominal wall with permanent stitches.
The procedure has been popular among urologist to treat stress incontinence. Although the sling procedure may result in higher success rates with incontinence it also can incur additional complications.This may occur where the surgeon ties the sling too tightly meaning the bladder may not empty partially or at all depending on how tight the sling is .This is uncommon.
It is more complicated than other surgeries for incontinence and always carries an element of risk such as: bleeding, difficulty urinating, infections, pain, and incontinence
The urethral sling can be used for women who have stress incontinence.It has about an 80% success rate to about 4 years and is commonly used by most surgeons now to treat incontinence that has failed with simpler treatments.
The procedures are done almost entirely through the vagina. A small incision is necessary just above the hairline or in the thigh folds for placement of stitches .
Since there is only a minimal incision made, there is less discomfort and inflammmation and recovery tends to be more rapid. Absorbable stitches are used in the vagina which eventually dissolve in time. These stitches are attached in behind the pubic bone . This is referred to as a retropubic type sling using permanent stitches just above the pubic hairline that may often feel like a little bump afterwards, but diminish with time.
Recovery time at home can be up to 4-6 weeks and women often suffer constipation after the procedure for a time afterwards.
Its important to inquire if you are older what further complications you might expect as a consequence of this and if there is a preferable alternative.
Generally the success rate is high though.
Using an absorbable synthetic or animal tissue for the sling is not as preferable as the patient’s own tissue because of the bodies rejection hence the use of the patients own tissue is a better option if possible.However many have used either synthetic or animal tissue as the actual sling ,with no complications.
If you are considering this procedure you need to ask your doctor or urologist about :
Its success rate ?
Does age of the patient affect recovery time?
What complications can you expect?
How long will the procedure take to do?
Has the doctor experience in sling procedures?
Should I consider other options before the sling?
How can I best prepare for the surgery?
All surgery whether it is day surgery or serious long and complicated procedures carry with it risks.
It is important all risk versus benefit be considered seriously before undertaking any procedure.
Remember there are no gaurantees of success and on occasions procedures can have unexpected consequences. All you can do if you feel you must proceed is weigh up the odds of success and go from there.
Be sure what you are doing is the last option not the first one for you to consider.