"Sling" Can Prevent Loss of Control.

• Position: Urinary stress incontinence surgery - Brief Article

It doesn't take much to trigger a leak--perhaps just sneezing, laughing, or lifting a child. So the millions of Americans with stress incontinence are constantly on guard, never knowing when the next wet patch will appear, Exercises and medication are the first line of treatment, but if they fail, surgery may be required.

A new outpatient procedure called TVT (tension-free vaginal tape) is being tested on female patients. Carl G. Klutke, associate professor of urologic surgery, Washington University School of Medicine in St. Louis (Mo.), reports that the majority of his patients who have undergone the procedure either were cured of stress incontinence or have improved a great deal.

Stress incontinence accounts for about half of the estimated 10,000,000 cases of incontinence among American women. Whereas other forms affect mainly older females, stress incontinence also plagues young women, threatening careers, social lives, and relationships with family members.

In 1996, a committee formed by the American Urologic Association reviewed outcomes of incontinence surgery. It concluded that the only effective vaginal procedure is placement of a sling beneath and around the bladder neck. The sling supports the weak sphincter muscle, helping it stay closed during coughing or straining. The sling can...