Sling Surgery for Stress Urinary Incontinence

A sling operation treats stress urinary incontinence, the leakage of urine on coughing, sneezing, laughing or exercise. A narrow strip of synthetic mesh tape or of your own tissue is placed under the urethra like a hammock, so that the urethra is supported and closes when abdominal pressure rises.

Around 80 to 90 percent of women are dry or much improved in the first years. It does not treat urgency incontinence from an overactive bladder, and synthetic mesh carries a small risk of long-term complications that has led some countries to restrict its use.

What Sling Surgery for Stress Urinary Incontinence involves

For a retropubic mid-urethral sling (TVT), a 1 to 2 centimetre cut is made in the front wall of the vagina under the mid-urethra. Needles carry the tape up on each side behind the pubic bone to emerge through two small cuts just above it. A cystoscopy checks that the bladder has not been pierced. The tape is left lying flat and tension-free, and the ends are trimmed under the skin. In the transobturator version the tape passes out through the groin creases instead. For an autologous fascial sling, a strip of the tough layer covering the abdominal muscles is harvested through a bikini-line cut and used in place of mesh.

Who is a good candidate for Sling Surgery for Stress Urinary Incontinence?

Surgery is considered after at least 3 months of supervised pelvic floor muscle training has not given enough improvement.

• Women with stress incontinence confirmed on examination with a cough test, with or without urodynamic studies
• Women who have completed their families
• Mixed incontinence in which the stress component is the main problem
• Men with mild to moderate leakage after prostate surgery, who may suit a male sling

It is usually not the right choice if:

• Pure urgency incontinence or an overactive bladder
• Women planning further pregnancies, as childbirth can undo the repair
• Difficulty emptying the bladder before surgery, which a sling may worsen
• Women who do not want synthetic mesh should discuss fascial sling, colposuspension or urethral bulking injections
• Severe male incontinence, where an artificial urinary sphincter works better

Technique options

• Retropubic mid-urethral sling (TVT): The most studied technique with the best long-term cure rates; small risk of bladder perforation.
• Transobturator sling (TOT): Avoids the space behind the pubic bone; slightly lower long-term success and a risk of groin pain.
• Autologous fascial sling: No mesh. Bigger operation with more voiding difficulty early on, but durable. Used after mesh complications or by preference.
• Urethral bulking injections: A quick clinic procedure with lower, shorter-lived success. An option for frail patients or those avoiding surgery.
• Male sling or artificial sphincter: For men after prostatectomy, chosen by severity of leakage.

What happens during your treatment

A mesh sling takes 20 to 40 minutes under spinal, general or local anaesthesia with sedation; a fascial sling takes 60 to 90 minutes. Before discharge, nurses check with a bladder scan that you can empty properly. Most women go home the same day or next morning. Pain is mild, mainly a bruised feeling above the pubic bone or in the groins.

Preparing for your trip

Plan for 5 to 8 days in Istanbul. Your surgeon reviews photographs and your medical history before you book, and you meet in person the day before surgery for examination, marking and consent with a professional interpreter.

• Stop smoking and nicotine at least four weeks before and after surgery; it is the single biggest avoidable cause of wound problems
• Tell the team about every medicine and supplement you take; blood thinners, some herbal products and hormone treatment may need to be paused on your doctor's advice
• Arrange for someone to travel with you or to be reachable, and keep the first days at home free of work and lifting
• Book a changeable return flight; your surgeon confirms when you are fit to fly

Recovery and results

Expect a slower urine stream at first. Walk from day one, return to desk work at 1 to 2 weeks, and avoid heavy lifting, high-impact exercise and intercourse for 4 to 6 weeks so the tape beds in. After a fascial sling allow 4 to 6 weeks off work. Report thigh or pelvic pain that persists, or vaginal discharge and pain with sex, as these can indicate a mesh problem.

• Back to everyday activity: 1 to 2 weeks; 4 to 6 weeks for a fascial sling
• When results show: Dry from the first days in most
• How long they last: 10 or more years for most; some recurrence

Safety, risks and revision policy

Most women have no complications, but you should be counselled on mesh-specific risks before consenting.

• Difficulty emptying the bladder, needing a temporary catheter in a few percent and occasionally sling loosening or division
• New or worse urgency and frequency in about 5 to 10 percent
• Bladder or urethral injury during insertion
• Mesh exposure through the vaginal wall in roughly 2 to 4 percent, sometimes years later
• Chronic groin, pelvic or sexual pain, more associated with the transobturator route
• Recurrent leakage over time
• Urinary tract infection
• Wound hernia or pain at the harvest site after a fascial sling

Every written proposal arranged through Clinic-Y states what the clinic covers if a correction is needed. Ask for it before you book, not after.

Cost of Sling Surgery for Stress Urinary Incontinence in Türkiye

Clinic-Y does not publish a single price for Sling Surgery for Stress Urinary Incontinence, because the honest figure depends on your case. What moves it:

• Mesh tape versus your own fascia
• Anaesthesia and length of stay
• Urodynamic testing beforehand
• Combined prolapse repair
• Treatment of any voiding problems afterwards

Send your photographs or reports and you receive written, all-inclusive proposals from suitable teams, side by side. Reviewing your case is free.

Frequently Asked Questions