Urinary Incontinence Treatment
Female Sling Procedures
For women who leak when they cough, laugh, lift, or exercise, a sling restores the support that childbirth, menopause, and time have weakened. It's an outpatient procedure, most women go home the same day, and the success rates are among the best in urologic surgery. Texas Regional Urology's board-certified urologists perform sling procedures with evaluation and follow-up at our offices in The Woodlands, Tomball, and Kingwood.
Restoring Support
What Is a Sling Procedure?
Stress urinary incontinence happens when the support beneath the urethra weakens. Under normal circumstances, a cough or a jump creates a sudden rise in abdominal pressure, and the urethra is compressed against firm underlying support, staying closed. When that support gives way, the pressure spike wins and urine escapes.
A sling restores it. A narrow strip of material is positioned beneath the mid-urethra like a hammock, providing a backstop the urethra can compress against during exertion. It isn't tight and doesn't obstruct — at rest it does nothing at all. It only comes into play at the moment pressure rises.
The procedure is performed through small vaginal and, depending on the approach, groin or lower abdominal incisions. It takes about 30 minutes and is typically same-day surgery.
Slings treat stress incontinence specifically. They do not treat urge incontinence, which arises from involuntary bladder contractions and responds to entirely different treatment. Distinguishing the two before surgery is essential, which is why evaluation matters. Learn more about urinary incontinence and overactive bladder.
A sling restores it. A narrow strip of material is positioned beneath the mid-urethra like a hammock, providing a backstop the urethra can compress against during exertion. It isn't tight and doesn't obstruct — at rest it does nothing at all. It only comes into play at the moment pressure rises.
The procedure is performed through small vaginal and, depending on the approach, groin or lower abdominal incisions. It takes about 30 minutes and is typically same-day surgery.
Slings treat stress incontinence specifically. They do not treat urge incontinence, which arises from involuntary bladder contractions and responds to entirely different treatment. Distinguishing the two before surgery is essential, which is why evaluation matters. Learn more about urinary incontinence and overactive bladder.
Why Women Choose It
Benefits of Sling Surgery
High Success Rates
Sling procedures are among the most effective and most thoroughly studied treatments in urology, with strong long-term results.
Outpatient Surgery
Most women go home the same day.
Short Procedure
Typically about 30 minutes under anesthesia.
Durable
Results generally last for years, and most women never need a repeat procedure.
Life Without Pads
The practical outcome most women describe is returning to exercise, travel, and social activity they'd quietly given up.
Who Qualifies
Am I A Candidate?
Sling surgery is for women with stress urinary incontinence — leakage with coughing, laughing, sneezing, lifting, or exercise — that hasn't resolved with conservative treatment. Pelvic floor muscle training, behavioral changes, weight loss, and treating constipation should be genuinely attempted first, since a meaningful number of women improve enough that surgery becomes unnecessary.
Evaluation before surgery establishes that the leakage is truly stress-type. That includes a history, a bladder diary, a pelvic examination, a cough stress test, checking that the bladder empties completely, and often urodynamic testing.
Women with mixed incontinence can still be candidates, but should understand that a sling addresses the stress component and the urge component will need separate treatment. Women planning future pregnancies are generally advised to wait, since delivery can undo the repair. Significant pelvic organ prolapse may need addressing at the same time.
Evaluation before surgery establishes that the leakage is truly stress-type. That includes a history, a bladder diary, a pelvic examination, a cough stress test, checking that the bladder empties completely, and often urodynamic testing.
Women with mixed incontinence can still be candidates, but should understand that a sling addresses the stress component and the urge component will need separate treatment. Women planning future pregnancies are generally advised to wait, since delivery can undo the repair. Significant pelvic organ prolapse may need addressing at the same time.
Recovery Time
What to Expect
Before Surgery
You'll complete the evaluation above, along with pre-operative labs and a urine culture. Blood thinners are typically stopped in advance, and you'll receive fasting instructions and need a ride home.
The Day of Surgery
The procedure is performed under general or regional anesthesia and takes roughly 30 minutes. Small incisions are made, the sling is positioned beneath the mid-urethra and tensioned carefully, and the incisions are closed with dissolvable sutures.
Going Home
Most women go home the same day. Before discharge we confirm you're emptying your bladder adequately; occasionally a catheter goes home briefly if swelling makes emptying difficult.
The First Two Weeks
Expect pelvic soreness, some vaginal spotting, and mild discomfort with urination. Walking is encouraged. Avoid lifting anything over about ten pounds, strenuous activity, and straining.
Weeks Three Through Six
Activity restrictions typically continue for around six weeks, including no intercourse, no tampons, and no heavy lifting. Most women return to desk work within one to two weeks.
Longer Term
Continence improvement is usually apparent immediately. Full healing and settling of any irritative symptoms takes several weeks.
Risks & Side Effects
Side Effects
Difficulty Emptying the Bladder
Some women have temporary trouble emptying after surgery, occasionally requiring a catheter for a short period. Persistent obstruction is uncommon and can be addressed.
New or Worsened Urgency
A minority of women develop urgency or urge incontinence after a sling, which is treated separately.
Urinary Tract Infection
Common enough after any urologic surgery and treated with antibiotics.
Pain
Pelvic, groin, or thigh discomfort in the early weeks is normal, and persistent pain is uncommon.
Mesh-Related Complications
Exposure of the mesh through the vaginal wall, or erosion into the urinary tract, is uncommon but possible and may require further treatment. See the FAQ below.
Recurrence
Leakage can return over time, and some women eventually need additional treatment.
Answers to your Sling Surgery Questions
Frequently Asked Questions
No — that was transvaginal prolapse mesh.
The FDA warnings and litigation that generated widespread concern involved mesh placed transvaginally to repair pelvic organ prolapse, a different product used for a different purpose. Mid-urethral slings for stress incontinence remain supported by major urologic and gynecologic organizations, and your surgeon will discuss the specific risks and alternatives with you.
Desk work in one to two weeks.
Most women return to office work within a week or two, with lifting and exercise restricted for about six weeks. Your surgeon will give you specific clearance.
The stress component, yes — not urgency.
Slings treat leakage caused by exertion and don't address urge incontinence from bladder contractions. Women with both will need separate treatment for the urge component.
It's strongly worth attempting.
Pelvic floor training resolves or substantially improves leakage for many women without any surgery. It also improves outcomes for those who do proceed.
Generally better to wait.
Pregnancy and delivery can undo the repair, so surgery is usually deferred until childbearing is complete. Conservative treatment can manage symptoms in the meantime.
Years, for most women.
Long-term studies show durable improvement, and most women never need a repeat procedure. Some experience gradual return of leakage over time.
Ready to stop planning around it?
Schedule a confidential evaluation.
Leakage is common, but it isn't something you have to live with. We'll determine what type you have and walk through every option, surgical and not.
