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The transobturator midurethral sling is one approach to a midurethral sling, which is considered the gold standard for treating stress urinary incontinence (SUI). SUI is when you involuntarily leak urine (pee) when sneezing, laughing, coughing or doing exercise. It is a very common condition and occurs in 1 in 3 women.
SUI occurs when the muscles and tissue that support the urethra (the tube that carries urine from your bladder to outside your body) are weakened. The midurethral sling uses a small piece of mesh to support the urethra. “Transobturator” describes the position of the sling, which curves around bony openings in the pelvis and out the groin (the area between your abdomen and thigh).
Transobturator midurethral slings are usually done by making a small incision (cut) in the vagina and two small incisions in the groin. Your surgeon will use a special device to place the mesh under the urethra, and the ends will exit through the groin incisions. There are also single-incision midurethral slings that may be appropriate for your symptoms that do not require any groin incisions (only a small vaginal one).
After the sling is in place, your doctor will insert a tiny camera called a cystoscope into your bladder to check that it was not injured.
You may be asked to undergo some bladder testing called urodynamic testing. You’ll need to attend a preoperative visit where you will talk with your provider about what to expect and undergo some basic lab work. If you need surgical clearance or prior authorization, you will be asked to get this before surgery.
Transobturator midurethral sling procedure by itself does not take a long time to perform, and you will be under general anesthesia. If performed by itself, it is an outpatient procedure, and you can go home the same day. However, if it is performed with other surgeries, such as ones to correct prolapse, some patients may need to stay in the hospital overnight.
You can expect some activity restrictions for about 6 weeks, but many patients can return to a normal routine shortly after surgery. Activity restrictions include:
The risk of complications from a transobturator midurethral sling is typically very low. As with any procedure, there is a risk of anesthesia problems, pain, bleeding, infection, blood clots or damage to nearby organs, but these are rare.
Risks specific to a transobturator midurethral sling include:
This procedure is a safe and effective surgery and midurethral slings are considered the gold standard for the correction of stress urinary incontinence.
Check your insurance plan benefits to see if your policy covers transobturator midurethral sling. If it does, our office will help you get prior authorization if your insurance policy requires it. If you have further questions, contact your insurance carrier.