Mesh sling

A synthetic mesh sling is made from a permanent medical-grade plastic called polypropylene. The mesh is placed under the urethra to give support and help prevent wee leaking when you cough, laugh or exercise.

The mesh sling may also be called a retropubic mid-urethral sling, tape, TVT, transvaginal tape, patch, ribbon, graft, hammock, plastic, polypropylene or gauze.

The sling is inserted through a small cut in the vagina. Small cuts may also be made in the upper thigh or just above the pubic bone, depending on the type of sling used. The mesh stays in your body permanently and works by supporting the urethra as your body tissue grows around it.

You should talk to your surgeon about the type of sling they use and the benefits and risks for you.

• This is short surgery, involving a day stay or an overnight stay in hospital.
• Recovery is quick, usually about 2 weeks.
• It is not highly invasive because it involves only small cuts above the pubic bone. Occasionally this may also need small cuts on the upper thigh.
• It can be done at the same time as other vaginal surgery, such as prolapse surgery.

• This surgery involves implanting a foreign material and there is a risk that your body may react to this.
• There is a higher risk of the bladder being injured during mesh insertion than in other procedures.
• If the sling is too tight and you have ongoing difficulty weeing, the sling may need to be loosened or cut.
• There is a risk of exposure or extrusion (the mesh could come through the tissue it was placed in). This may lead lead to the need for mesh removal surgery.
• Pelvic surgical mesh procedures are associated with a higher risk of chronic (persistent) pain compared with non-mesh alternatives. This pain can be complex and difficult to treat and may be irreversible (even after the mesh is removed).
• It may not be possible to completely remove the tape or sling, especially if complications develop years after surgery.

Long-term risks remain unknown.

• There is a risk of mesh exposure. This is when the mesh comes through into your vagina or enters the bladder, urethra, surrounding tissue or nerves and organs. This can happen years or decades after mesh is inserted.  If you have surgical mesh, it is important to tell your healthcare provider if you are experiencing pain in your vagina, groin, pelvis, buttocks, thigh or whole leg.
• There may be a link between mesh and worsening of existing auto-immune conditions, or a new auto-immune condition developing such as allergies, rheumatoid arthritis, lupus and multiple sclerosis. Research is ongoing, and this link has not been fully established.
• Occasionally if the mesh sling is placed too tightly and you have ongoing difficulty weeing, the sling may need to be cut or loosened. This is usually done within 6 weeks of insertion.

This surgical option usually involves a day in hospital, so you go home the same day as the surgery. In some cases, you may need to stay overnight.

For this surgical option, 1 to 2 weeks off work is normal.