Which patients are Needleless candidates?
The Needleless single incision TOT sling is used to treat female stress urinary incontinence. The selection of patients should follow the same indications that have been used for TVT and TOT slings. Every patient with stress urinary incontinence may be suitable to be treated with the Needleless sling. The expected results are the same as with traditional incontinence meshes, but minimizing collateral effects as groin pain.
How does it work?
The Needleless creates a new sub urethral support like a TOT mesh. Normally, the urethra is supported by the pelvic floor muscles preventing involuntary urine loss. In women with SUI, the pelvic floor is weak and the tissue can´t support the urethra properly under stress.
The Needleless TOT single incision sling is placed to support the urethra under local anaesthesia and with no skin incisions. The sling is placed through a single vaginal incision and conducted by a surgical forceps deeply into the internal obturator muscle. The needleless is incorporated into and supported by the internal obturator muscle without crossing the internal obturator membrane to minimizing groin pain.
The Needleless sling has a patented pocket positioning system that allows its adjustment and repositioning in both sides and in both directions during surgery to adapt to patients need.
Do I need to leave a space under the urethra?
No, the sling should be placed in full contact with the sub urethral tissue.
How deep should the Needleless be placed?
The first arm should be pushed deeply into the internal obturator muscle until the blue suture mark is 1 cm deeper in relation to the urethra. The second arm should be pushed into the contralateral side until the middle of the mesh is centred under the urethral middle line.
How many days of hospitalization are required after a Needleless surgery?
The Needleless single incision sling can be placed under local anaesthesia as an outpatient procedure with no hospitalization. If there are no complications, the patient may return home the same day. The Needleless sling may be also used in patients with additional surgical procedures like hysterectomy, cystoceles, etc... In these cases, the additional procedures requirements will dictate the hospitalization days.
What to expect after the procedure?
Most patients experience continence immediately after the procedure and are able to return home a few hours after surgery. When treated with Needleless, patients will have no external skin incisions and less pain compared to a TOT procedure.
For approximately four to six weeks, patient should avoid sexual intercourse, heavy lifting and exercise. Patient can return to other normal daily activities at doctor's discretion, often within a few days.
What does the name Needleless mean?
This sling is placed with no sharp Needles crossing the skin as the TVT or TOT, providing the patient a better recover with less pain.