Adjustable Sling Provides a Solution for Incontinence
Samuel S. Lentz, MD, with nurse practitioner, Amy Hensley
Wake Forest Baptist urogynecologists Samuel S. Lentz, MD, and Steven H. Berliner, MD, have added another approach to their repertoire of therapies for treating urinary incontinence—the adjustable urethral sling.
“A common solution for incontinence is the tension-free urethral sling. It works well; however, if the patient has persistent incontinence after placement, you can’t adjust the sling,” said Lentz. “With the adjustable sling, you can ‘fine-tune’ it for the patient.”
Under general or spinal anesthesia, the sling is placed beneath the urethra through a small vaginal incision. Two permanent sutures attached to the sling are passed through a small abdominal incision. The sutures are then spooled into an adjustment device called a varitensor which remains under the skin. The varitensor is accessible to adjust the tension on the sling one to two days after surgery. The adjustment can also be performed at a subsequent time, even months after surgery, under local anesthesia in the office.
“The adjustable sling has particular benefit in women who have urinary sphincters which have failed, or who have had previously failed urinary incontinence procedures,” said Berliner.