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Sneezing, coughing or laughing can mean big trouble for millions of women, and some men, who suffer from stress urinary incontinence (SUI), which is the unintentional leakage of urine. A bladder sling, also known as a pubovaginal sling, is used in a minimally invasive outpatient surgical procedure for the purpose of preventing these embarrassing mishaps. Ribbon-like and porous in size and appearance, it usually is fabricated with a synthetic mesh material, although it also can be constructed of human tissue. In one continuous strip, the bladder sling rests under the bladder neck or mid-urethra and attaches to both ends of the pelvis, such as the pubic bones or pelvic side walls. The support and light compression of the bladder sling can prevent the unintentional relaxation of the muscle and thereby halt the leakage in most cases.
When the urinary system is functioning normally, the brain sends signals to tighten the bladder muscles while relaxing the urinary sphincter muscles, and this allows the urine to pass. For people with SUI, the sphincter muscle that surrounds the urethra is weak, so the slightest pressure forces the urine out prematurely and usually at inopportune moments. The bladder sling acts as a reinforcement, or hammock, for the weak muscles and the urethra, a tube that runs from the bladder to the outside of the body.
The risk of developing SUI in women increases in part from lifestyle factors, such as being overweight or smoking cigarettes, but the risk also can increase after childbirth, hysterectomy or menopause. Sometimes, the cause of SUI is unknown. The condition is less common in men, although roughly 5 percent of the male population suffers from the disorder to some degree, often as a result of surgery to remove all or part of the prostate gland.
The bladder sling has a high success rate and has provided countless men and women with a renewed sense of freedom and improved quality of life. The recovery period after the sling procedure can be long and arduous, so a urologist usually will recommend the procedure only for severe cases in which the problem cannot be controlled by other means. As with any surgical procedure, there always are risks involved.