What is a mid-urethral sling and what condition does it treat?

• A. A sling placed above the urethra to provide support for the bladder neck.
• B. A sling placed under the urethra to provide support and improve urethral closure; treats stress urinary incontinence.
• C. A sling placed around the bladder to prevent leakage during coughing.
• D. A device implanted in the urethra to permanently prevent leakage.

Answer: (B)

The idea here is to provide mechanical support to the urethra so it can stay closed when pressure in the abdomen rises, like during coughing or sneezing. A mid-urethral sling is a narrow band placed under the middle portion of the urethra. It works like a hammock, supporting the urethra and helping it close properly during activities that would otherwise cause leakage. This directly addresses stress urinary incontinence, which happens when the pelvic support or urethral sphincter isn’t enough to keep urine from leaking with increased abdominal pressure. By stabilizing the urethra at the level where it matters most, the sling reduces leakage episodes. Descriptions that place a sling above the urethra, around the bladder, or inside the urethra to block leakage don’t match how a mid-urethral sling works.