The Sling Procedure
The sling procedure is often used for women with severe stress incontinence caused by weak sphincter muscles, women who have had previous bladder surgery that failed, or women who have had a hysterectomy.
In this operation, a sling is placed at the bladder neck, like a hammock, to support the bladder neck and prevent urine from leaking.
Studies have found that the sling procedure is successful in 80 to 90 percent of cases.
Tension-Free Transvaginal Tape (TVT)
This procedure, developed in 1995, uses a nylon mesh-like tape that is surgically inserted through the vagina to support the urethra. After a few weeks, tissue begins to form around the tape, holding it in place. The TVT works by compressing the urethra closed during movements that increase abdominal pressure, such as coughing or running.
However, unlike the sling procedure, no sutures are needed and the procedure can be done as day surgery using local anesthetic and intravenous sedation. TVT appears to be successful in about 85 percent of cases and reduces symptoms for an additional five to seven percent of women.