Bladder Slings – for stress urinary incontinence

Q: What is a SLING for Stress Urinary Continence?

A: A sling is small strip of a very soft and flexible synthetic material. The sling integrates with your body’s tissues and forms a “hammock of support” under your urethra. Biomedical engineers and clinical researchers have developed slings to be compatible with your bodies’ tissues.

The size of a sling is usually about 0.6 inches wide and can vary in length from 3.4 inches or more depending on the product used and your anatomy. As technology has advance in the surgical correction of stress incontinence, sling procedures have now become the “Standard of Care” or “Gold Standard Procedure” in the industry.

Q: How is a sling placed for bladder leakage?

A: Generally on an outpatient basis, Dr. Crawford performs the procedure under local anesthesia with IV sedation (or twilight). A small incision of about 1 inch is made inside the vagina, under the floor of the bladder. Small instruments are utilized to place the tension free mesh into place using  no stitches. The tissue itself holds the sling in place. Scar tissue will form in and around the sling to keep it from moving.

How your bladder should work - before urinary stress incontinence.

What happens when you have urinary stress incontinence

Q: How long does a sling surgery take?

A: Depending on a patient’s specific medical situation, it normally takes 15 to 20 minutes. It’s typically an outpatient procedure allowing you to return home after and hour or so (the same day). Should this procedure be a part of another condition such as a fallen bladder, uterus or rectum, additional surgery may be required. Dr. Crawford will discuss with you in detail all that may apply to your medical needs.

Q: How long is the recovery time?

A: Depending on a patient’s overall medical condition, recovery periods can vary. Dr. Crawford will give patients an approximate window of recovery time based on their individual situations. Most patients report their post-op pain from a sling procedure as “mild”, only. Patients are up and around as soon as the anesthesia wears off, and less than half require prescription strength medication. Significant discomfort rarely lasts more than a couple of days. Normal activity such as walking, driving and light chores can be resumed immediately, but it is advised to avoid heavy lifting or straining for at least 10 days.

Q: Are there complications that can occur utilizing a sling for SUI?

A: Dr. Crawford will explain the risks and benefits associated with vaginal mesh placement. As with any medical procedure or surgery, complications can occur, although an outcome of complications is relatively rare for this particular procedure. This procedure can result in exposure (a small amount of the sling material exposed into the vagina), infection, irritation or inflammation as an example. These problems can often be treated at Dr. Crawford’s office on an outpatient basis. More serious complications could include pain, infection, bleeding, organ perforation or urinary problems as an example. Once again, Dr. Crawford will take you through the risks and corrective measures should they occur.

Q: Is a sling procedure guaranteed to cure my incontinence symptoms? If not, can I still pursue different procedures?

A: There is no surgery for incontinence that has a 100% cure rate. Current slings for bladder leakage have been studied for more than 15 years and have a reported satisfaction rate of 80% to 95%. Should you fall within the small percentage of those that do not achieve the desired result, you can still consider other incontinence procedures.

Q: Is a sling a good option for me?

A: Dr. Crawford can help you make this decision after an initial consultation. You should discuss all of your options in order to determine which treatment plan is the most beneficial for your specific symptoms and situation. This is a personal choice that Dr. Crawford is ready to discuss with you.  That being said, synthetic mid urethral slings are very well suited for the vast majority of female patients with moderate to severe bladder leakage caused by exertion.

“One call does it all” ………. for Phoenix 602-457-7066;  for Ahwatukee call 480-582-4717

Neuromodulation for Over Active Bladder 

Q: What are some of the treatments for OAB?

A: First round treatments of OAB have traditionally been Kegel’s exercises, bio-feedback, physical therapy, fluid and diet regulation and medication. However, many patients have been displeased with the awkwardness and time involved with exercises and therapy. Many patients have failed to get the desired relief from medications or have unpleasant side effects. Recently though, there has been a new emergence in the management of OAB. It is called Neuromodulation and the specific device is called INTERSTIM.

Q: What is the InterStim device?

A: InterStim is an implantable device, like a pacemaker, that addresses the communication between the nerves that control the bladder and the brain. If the nerves don’t communicate correctly to the brain, the bladder will not function properly. InterStim Therapy works with the sacral nerves, located near the tailbone. The sacral nerves control the bladder and muscles related to urinary function. If you have tried other treatments but still have difficulty with bladder control, it’s probably an option you should consider.

Q: Why Dr. Crawford and InterStim?

A: Although InterStim is a relatively new break-through treatment, more than 100,000 people have received InterStim Therapy worldwide. It has been FDA approved since 1997 for urge incontinence and since 1999 for urinary retention and urgency-frequency. Being rather new, only a select few doctors in Phoenix actually have become trained and certified for InterStim use.
Dr. Crawford is one of these select few.

If you have OAB (urge incontinence or urge frequency) or urinary retention, have tried other treatments such as fluid and diet modifications, physical therapy, medications and still experience OAB symptoms, you should make an appointment with Dr. Crawford to see if InterStim Therapy is an option for you.

Q: Is InterStim covered by my insurance?

A: In most cases, InterStim Therapy is a covered benefit of your health insurance. Dr. Crawford’s office can can determine your plan’s benefits for you, saving you the hassle and time.

Q: What are the benefits of InterStim Therapy?

A: InterStim Therapy may reduce symptoms for many people who suffer from overactive bladder. InterStim Therapy is reversible and can be discontinued at any time by turning off or removing the device. Unlike other surgical treatment options for OAB, InterStim Therapy starts with an evaluation, where you can experience how it feels and see if it will help reduce your symptoms prior to to going forth with the implant procedure.

Q: What are the risks of InterStim Therapy?

A: Implanting an InterStim Therapy system has risks similar to any surgical procedure, including swelling, bruising, bleeding and infection. Talk with Dr. Crawford about ways to minimize these risks.