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Stress urinary incontinence is a condition in which unwanted urination is triggered by laughing, sneezing, or pressure applied to the abdominal wall. This condition is more frequent in women due to differences in anatomy of the urethra between males and females.

Urethral Sling Purpose

Severe stress incontinence can be treated surgically, or with the implantation of a urethral or bladder sling. A urethral sling can be made of biological material, such as ligaments and tendons, but it can also be synthetic. Anyway, a urethral sling is used to strengthen the wall of urethra and help the function of urethral sphincters, so that the urine cannot come out unexpectedly. Although this intervention is proven to be helpful, it produced complications and side effects in a significant number of patients. Here we discuss some of the most common complaints of patients who underwent urethral sling placement.

Early Postoperative Period

During the first few postoperative days, a urinary catheter is required in order to evacuate the urine from the bladder until normal function restored. Pain can be expected during this period, but it should subside during the first two postoperative weeks. Constipation is also listed among the early postoperative complications.

Prolonged Urination Difficulties

As mentioned earlier, difficulties with urination are normal during the first 2 to 3 days after surgery, but if the problem persists, you should refer it to your doctor. Urgency for urination can also appear. These complications are caused by the sling pressuring the urethra a bit more than needed, so urine is eliminated in small volume but multiple times. Urination difficulties may require a new surgical procedure to fix the problem.

Prolonged Postoperative Pain

Postoperative pain is usually managed with standard analgesics, but it represents a complication of the surgery if it lasts longer than expected. In some cases, the pain is related only to urination and/or sexual intercourse, but in other patients, the pain is constant an even disabling.

This complication can affect physical and mental health, as the person is prevented from performing some everyday activities. Pelvic pain after sling placement can be caused by nerve compression, infection, excessively tight sling placement, and other factors. Every case of prolonged pain should be reported to your doctor, making necessary examinations to prevent further organ damage possible. The pain can also require revision surgery.

Infection

Every surgical procedure carries the risk of infection. Common symptoms include painful urination, fever, and a bad urine smell. Complicated urinary infections require special attention as they can influence recovery, especially if they are recurrent. Infections are more frequent in patients with synthetic urethral slings.

Urethral sling placement is usually performed with the aim to avoid classic surgery which is more invasive, but as it is linked to many complications, the question remains which type of treatment is better. The decision should be made by the urologist for every patient individually, based on the patient's current condition.

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