Prof. Dr. Emel Akoğlu
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- 57+years exp.
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Kidney & Bladder
Sling procedure
What a sling procedure is, how retropubic, transobturator, single-incision and fascial slings differ, what a male sling does, what studies show about success, approximate costs in Turkey against the UK, US and Germany, a recovery timeline, mesh-related risks and how to check a urologist or gynaecologist.
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Prof. Dr. Zerrin Biçik Bahçebaşı
UrologyVerified
- 37+years exp.
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Sling procedure in Turkey: what it is and how it works
A sling procedure is a short operation that places a narrow strip of supporting material under the urethra (the tube that carries urine out of the bladder) to stop leakage when you cough, sneeze, laugh or exercise. This is called stress urinary incontinence, and it happens when the urethra and its supports are too weak to stay closed under pressure. The sling acts like a hammock: when pressure in the abdomen rises, the urethra is compressed against the strip and stays closed. Most slings in women are synthetic mesh tapes placed through small cuts; some are made from the patient's own tissue. In men, a similar sling is used for leakage after prostate surgery. Urology and gynaecology departments in Turkey perform these operations routinely.
This guide explains the types of sling, how it differs from other treatments, what the evidence shows, what it costs in Turkey compared with the UK, US and Germany, recovery, risks (including the mesh debate) and how to check a clinic. A sling is only appropriate for stress incontinence; it does not treat an overactive bladder. See our urology treatments in Turkey hub for the other options.
Which type of sling procedure is used: TVT, TOT, mini-sling or fascial?
The main sling types differ in the path they take and the material used.
- Retropubic sling (TVT and similar): a mesh tape passes behind the pubic bone, entering through the vagina and exiting through two small cuts above the pubic hair line.
- Transobturator sling (TOT/TVT-O): the tape passes through the obturator foramen in the groin, avoiding the area behind the pubic bone and so lowering the risk of bladder injury.
- Single-incision (mini) sling: a shorter tape fixed in the tissue through one vaginal cut, with less dissection but less long-term evidence.
- Autologous fascial sling: a strip of the patient's own tissue, taken from the abdominal wall or thigh, is used instead of mesh. It needs a bigger operation but avoids synthetic material.
- Male sling: a mesh or bone-anchored strip supports the urethra in men with mild to moderate leakage after prostate surgery.
| Type | Best suited to | Typical limits |
|---|---|---|
| Retropubic mesh tape | Stress incontinence, including weaker urethral closure | Slightly higher risk of bladder or bowel injury and voiding difficulty |
| Transobturator mesh tape | Women with typical stress incontinence | Groin or thigh pain in some; may be less effective when closure is poor |
| Fascial sling | Patients who prefer not to have mesh; repeat operations | Larger incision, longer recovery, donor-site discomfort |
Is it stress incontinence or an overactive bladder?
The most important step before any sling is the correct diagnosis. Stress incontinence (leaking with effort) is treated with a sling; urgency incontinence (a sudden strong need to pass urine that you cannot hold) is caused by bladder muscle overactivity and is normally treated with bladder training and drugs, not surgery. Many women have a mix, and operating when urgency dominates can leave that problem unresolved or worse. A good clinic will ask about your symptoms, test a urine sample, examine you, ask you to keep a bladder diary and, in many cases, carry out urodynamic testing (pressure measurements during bladder filling). Drug options are described in our guide to medication therapy for urinary incontinence.
Does a sling procedure work, and how long does it last?
For stress incontinence the evidence is among the strongest in urogynaecology. Large reviews, including those that informed national guidance, report that most women are cured or much improved after a mid-urethral sling, with success often quoted at around 80 to 90 per cent at one year and good results in studies that follow women for ten years or longer. It tends to work less well if the urethra's closing muscle is very weak, if you have severe urgency symptoms, or after earlier failed surgery. Your own tissue strength and weight also matter. Fascial slings have a long track record but fewer modern comparisons. No surgeon can promise to cure incontinence entirely, and a few women need a second procedure.
How much does a sling procedure cost in Turkey compared with the UK, US and Germany?
The figures are approximate ranges for the operation with hospital stay in a private hospital, not quotes from any hospital.
| Country | Approximate cost range |
|---|---|
| Turkey | €2,500 – €5,500 |
| United Kingdom | €4,500 – €9,000 |
| United States | €8,000 – €20,000 |
| Germany | €4,000 – €9,000 |
The price changes with the type of sling (a fascial sling or revision costs more), whether urodynamic tests and scans are included, the type of anaesthesia, the nights in hospital and whether another operation, such as a prolapse repair, is done at the same time. A package usually includes pre-operative tests, surgeon and anaesthetist fees, the sling, hospital stay, medication, a follow-up check and transfers. Ask the clinic to name the tape or technique and to list what is included.
How is the sling procedure done, step by step?
The operation takes about 20 to 40 minutes. It is done under spinal, general or sometimes local anaesthesia with sedation. A catheter is placed in the bladder; for a retropubic or transobturator tape the surgeon makes a small cut in the vaginal wall under the urethra and two small cuts in the groin or above the pubic bone, passes the tape through, and adjusts it so that it lies without tension under the mid-urethra. A cystoscopy (a look inside the bladder) is often done to check there is no injury. The cuts are closed with a few stitches or glue. Many patients go home the same day or after one night, with or without a catheter.
Who is a good candidate, and who is not?
Good candidates are adults with confirmed stress incontinence that affects daily life and has not improved with pelvic floor exercises, weight loss or lifestyle changes over a few months. A sling is usually delayed if you are planning more children, have an untreated urine infection, have a bladder that does not empty properly, or have severe urgency. Women with a prolapse may need a combined procedure. Men with leakage after prostate surgery are assessed separately; for more severe leakage, an artificial urinary sphincter may be the better-matched option. Tell the surgeon about previous pelvic surgery, radiotherapy and any medication you take.
How long is recovery, and when can I fly home?
| Time after surgery | What to expect |
|---|---|
| Day 0–1 | Catheter removed or bladder emptying tested; mild pain, small spotting |
| Days 2–7 | Walking, light activity; groin soreness; discharge or spotting settles |
| Weeks 2–4 | Return to desk work from about one week; avoid lifting, straining and intercourse |
| Weeks 4–6 | Sex and gentle exercise usually resume after the surgeon agrees |
| 6 weeks and after | Normal activity; the full effect on leakage is judged at three months |
Most patients stay three to five nights in Turkey so that the bladder-emptying check and first review are done before travel. Short flights are normally fine once the surgeon agrees. Report fever, inability to pass urine, heavy bleeding or severe pain at once.
What are the risks of a sling, and what about mesh?
Risks of any sling include bladder or urethral injury at the time of surgery, difficulty emptying the bladder, new urgency, urinary infection, bleeding and pain. Mesh-specific problems are mesh exposure through the vaginal wall, erosion into the urethra or bladder, long-term pain and pain during sex; they are uncommon but can be serious and may require further surgery. In the UK, mesh slings were paused in 2018 and later resumed under tighter safeguards, and the US Food and Drug Administration has issued safety communications on mesh for prolapse, which is a different use from the mid-urethral tape. For this reason you should have a full conversation about alternatives, including a fascial sling, before consenting. The NHS and national urology societies provide patient information on all of these points.
How do I choose a surgeon and hospital, and what are the red flags?
Check that the surgeon is a urologist or urogynaecologist with regular experience of sling surgery, that the hospital is licensed, that you are told the tape brand and technique, and that you receive a written plan and price after your symptoms and tests have been reviewed. Red flags include a quote without any assessment, no explanation of mesh risks, pressure to book quickly, no named surgeon, no mention of alternatives and promises of a cure. Read how our process works and start with our free quote page.
Questions to ask the clinic:
- Do I have stress, urgency or mixed incontinence, and what tests show this?
- Which sling type do you recommend, which brand, and why not the others?
- What are the mesh-related risks, and is a fascial sling an option?
- How many sling operations does the surgeon do each year?
- How many nights are included, and who treats me if there is a problem after I return home?
Hospitals with Urology in Turkey
Frequently asked questions
It is a short operation in which a narrow strip of mesh or the patient's own tissue is placed under the urethra to support it. The aim is to stop urine leaking during coughing, sneezing, laughing or exercise.
Both are mesh tapes under the urethra. TVT passes behind the pubic bone and TOT passes through the groin. TOT lowers the risk of bladder injury, while TVT may suit women whose urethra closes weakly.
For stress incontinence many studies report that most women are cured or much improved, often quoted at 80 to 90 per cent at one year. It works less well for urgency incontinence, so accurate diagnosis matters.
Approximate ranges are €2,500 to €5,500 in Turkey, against roughly €4,500 to €9,000 in the UK. The type of sling, tests, anaesthesia and hospital nights change the price; the hospital confirms it in writing.
Most women return to desk work after about a week, avoid lifting and sex for four to six weeks, and judge the full effect after about three months. Bladder emptying is checked before discharge.
You will feel soreness in the vagina and groin for a few days, usually controlled with simple painkillers. Severe or lasting pain should be reported to the surgeon.
Mid-urethral mesh tapes are widely studied and effective for most women, but mesh can cause exposure, erosion or long-term pain in a small number. Ask about a fascial sling, which uses your own tissue.
Yes. A male sling supports the urethra in men with mild to moderate leakage after prostate surgery. For more severe leakage an artificial urinary sphincter may be preferred.
It is usually delayed if you plan more children, have an infection, empty the bladder poorly or have mainly urgency symptoms. A urologist reviews your tests before advising surgery.
Plan about three to five nights so that the surgeon can check bladder emptying and your first healing. Fly home only when the team agrees and arrange follow-up at home.
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