How does mid-urethral sling work?

Stress urinary incontinence happens when pressure on the bladder rises faster than the urethra can close. The sling sits under the middle section of the urethra like a hammock. It does not squeeze the urethra at rest. When you cough, laugh, run or lift, the sling provides a firm surface that helps the urethra stay closed.

The sling may be placed through a small vaginal incision, with the supporting arms passing behind the pubic bone or through the groin. It is commonly made from surgical mesh. The operation is planned after assessing your leakage, pelvic health and ability to empty your bladder.

Your clinician may ask about bladder symptoms, examine your pelvic floor and arrange urine testing or urodynamic testing when the diagnosis is uncertain. After surgery, follow instructions about wound care, activity, lifting and sex while tissues heal. Temporary burning, urgency, pelvic soreness or difficulty emptying the bladder can occur. Attend the planned review so persistent symptoms can be assessed.

Read more about [Mid-Urethral Sling](/treatments/gynaecological-surgery/mid-urethral-sling/), [Stress Urinary Incontinence](/conditions/stress-urinary-incontinence/) and [Surgical Mesh](/materials/surgical-mesh/). Non-surgical care may include [Pelvic Floor Physiotherapy](/treatments/pelvic-floor-and-rehabilitation/pelvic-floor-physiotherapy/).

Contact your surgical team for increasing pain, fever, worsening redness or discharge, new heavy bleeding, or urine leakage that suddenly becomes much worse. Seek urgent help if you cannot pass urine, have severe abdominal pain, chest pain or breathlessness. Persistent pain with sex, recurrent urinary infections or exposure of mesh through the vagina also needs clinical assessment.

Ask which sling route is being considered, why it suits your leakage pattern, what non-surgical options remain, and how bladder emptying will be checked afterwards. Discuss mesh-specific risks, recovery restrictions and what symptoms should prompt an urgent call.