​ Mr Paul Curtis MBChB  FRCOG

​   Consultant Gynaecologist


Call:  01483 451669

Incontinence

Urethral Support Sling (SPARC)

A urethral support sling is a narrow strip of material that acts like a hammock to support the bladder neck and urethra and to allow the sphincter to close more effectively.


Surgery


The procedure is performed under general anaesthetic and usually takes around an hour.  During the operation two small incisions are made in the abdomen and a third is made in the vagina.  The sling is inserted through the incision in the vagina and guided into position behind the urethra.  The two ends of the sling are secured under the skin through the incisions in the abdomen and are not visible.


Recovery


After the operation you will usually need to stay in hospital for 1 or 2 nights and will have a catheter in place to drain urine from the bladder.  The catheter will usually be removed before you leave hospital and you may be prescribed antibiotics to help prevent infection.


You should avoid any strenuous activity or lifting for at least six weeks following your procedure and you will be given advice and guidance from a physiotherapist to ensure that your surgery is as successful as possible.

procedures are a common treatment for stress incontinence.

Why Does Stress Incontinence Occur?

A colposuspension procedure aims to strengthen the pelvic floor muscles, thereby helping to lift the bladder and uterus back into the correct position.


Surgery


The procedure is performed under general anaesthetic and an incision will be made in your abdomen along the bikini line.  The bladder and uterus are moved back into the correct position. Stitches are used to strengthen the pelvic floor and then the incision is closed and a dressing is applied.


Recovery


After the operation you will probably need to stay in hospital for 2 or 3 nights.  You will have a catheter in place and possibly a drain in your abdomen to prevent any blood from building up.  These are usually removed after a day or two.  You will probably be in some discomfort and pain relief will be provided as required.


Recovery from this type of operation will take longer than a urethral sling procedure as you will have a wound in your abdomen and the stomach muscles will need time to heal.  Lifting should be avoided for at least 12 weeks.  A physiotherapist will offer help and guidance to ensure that your recovery is as smooth as possible.

Bladder Slings or Bladder Neck Suspension

Colposuspension

Urine is produced in the kidneys and passes through tubes called the ureters, into the bladder. As the bladder fills, it expands and the muscles around it, called the detrusor muscles, stay relaxed.  The urethra is a tube that runs from the neck of the bladder to the outside of your body and it has a valve, called a urinary sphincter that keeps the opening at the bottom of the bladder tightly closed.  The thick, spongy walls of the urethra help to form a watertight seal when compressed by the sphincter.


When you need to empty your bladder the detrusor muscles contract to help force the urine out of your body and the sphincter opens to allow the urine to pass through.


The sphincter, bladder, bladder neck and urethra must be in the correct position in order to work properly. They are held in the correct position by the pelvic muscles and other support structures.  If the pelvic floor muscles are not strong enough to support a full bladder it will allow the sphincter to open and for urine to leak out.  Therefore, with the added pressure of coughing, sneezing or lifting for example, leakage may occur.


Previously colposuspension was the most commonly performed procedure in the treatment of stress incontinence.  However, in recent years the urethral tape suspension procedure has become increasingly popular and is usually the preferred choice of treatment.