Fellowship-Trained Urogynecologist
Urogynecology & Reconstructive Pelvic Surgery
Green Bay, Wisconsin
✓ Medically reviewed March 2026
Sling Procedures for Urinary Incontinence
Sling procedures are surgical treatments primarily used to address stress urinary incontinence (SUI) in women. These procedures involve placing a small strip of material to support the urethra, helping to prevent urine leakage during physical activities.
How Sling Procedures Work
Sling procedures work by:
- Supporting the urethra and, sometimes, the bladder neck
- Providing compression to the urethra during moments of increased abdominal pressure
- Restoring the urethra to a more anatomically correct position
Midurethral slings are the most commonly performed surgery for stress urinary incontinence worldwide, and for good reason — they’re minimally invasive and have strong long-term data behind them.
Types of Sling Procedures
There are two main types of sling procedures:
1. Mid-Urethral Slings
- Most common type of sling procedure
- Uses a thin strip of synthetic polypropylene mesh
- Subtypes include:
- Retropubic
- Single-incision mini-slings
- Transobturator
2. Pubovaginal Slings
- Uses a strip of the patient’s own tissue, typically from the abdominal wall
- May be preferred for patients who cannot have synthetic materials
- Placed at the bladder neck rather than mid-urethra
How the procedure works
- Preoperative evaluation to confirm SUI and rule out other conditions
- General or regional anesthesia
- Small incisions in the vagina and sometimes the lower abdomen or groin
- The sling material is positioned under the urethra
- Incisions are closed with dissolvable sutures
- Most patients go home the same day
Benefits of Sling Procedures
- High success rates (80-90% cure or significant improvement)
- Minimally invasive with quick recovery
- Long-lasting results
- Can be performed as an outpatient procedure
Most patients are surprised by how quickly they recover and how well the sling works.
Potential Risks and Complications
Like any surgery, sling procedures carry some risks:
- Difficulty urinating or incomplete bladder emptying
- Urinary tract infections
- Pain (usually temporary)
- Mesh erosion or exposure (with synthetic slings)
- Rarely, injury to nearby organs
I go through all of these with you before surgery so you know what to expect.
Who is a good candidate for a sling procedure?
A sling procedure may be a good option if you:
- Have stress urinary incontinence confirmed on evaluation
- Want a surgical solution for your leakage
- Are in good overall health for surgery
It’s not the right fit for everyone, and we’ll talk through whether it makes sense for your situation.
Recovery and long-term outlook
Recovery is similar to my other minimally invasive procedures — let your body be your guide, and if it hurts, don’t do it. Most patients are back to their normal routine within a few weeks. Success rates are high, with 80-90% of women experiencing cure or significant improvement in their leakage.
One thing to know: sling procedures treat stress incontinence specifically. If you also have urge incontinence, we may need to address that separately.
References
- Ford AA, Rogerson L, Cody JD, Aluko P. Mid-urethral sling operations for stress urinary incontinence in women. Cochrane Database Syst Rev. 2017;7(7):CD006375. doi:10.1002/14651858.CD006375.pub4
- Brubaker L, Norton PA, Albo ME, et al. Adverse events over two years after retropubic or transobturator midurethral sling surgery: findings from the Trial of Midurethral Slings (TOMUS) study. Am J Obstet Gynecol. 2011;205(5):498.e1-6. doi:10.1016/j.ajog.2011.07.011
- Kobashi KC, Vasavada S, Jain P, et al. Updates to surgical treatment of female stress urinary incontinence (SUI): AUA/SUFU guideline (2023). J Urol. 2023;209(6):1091-1098. doi:10.1097/JU.0000000000003435
- Stewart JR. Midurethral sling procedures for stress urinary incontinence. In: Pasic RP, Brill AI, eds. Practical Manual of Minimally Invasive Gynecologic and Robotic Surgery: A Clinical Cook Book. 3rd ed. CRC Press; 2018.