Compare urethral sling surgery with bulking agents for stress incontinence and name a key post-operative nursing consideration.

• A. Sling provides a supportive urethral retropubic wrap; bulking agents inject into the urethral sphincter to increase outlet resistance; both require activity restrictions and monitoring for urinary retention and infection post-op
• B. Sling reduces bladder capacity; bulking decreases sensation; monitor dehydration
• C. Sling is non-surgical; bulking is surgical; monitor for blood pressure changes
• D. Sling uses injections; bulking uses physical support; monitor for pain only

Answer: (A)

Urethral sling surgery and bulking agents address stress incontinence by different mechanisms, so understanding how they work helps you predict what to monitor after each procedure. A sling provides a supportive urethral retropubic wrap that mechanically lifts and stabilizes the urethra, helping it stay closed when pressure rises. Bulking agents are injectable materials placed around the urethral sphincter to thicken the urethral outlet and increase resistance, making leakage less likely during stress.

A key nursing consideration after either approach is managing healing and watching for common post-op complications. Activity restrictions help protect the surgical area or injected tissue as it settles, reducing the risk of displacement or injury. Urinary retention is a frequent concern after a sling due to edema or obstruction, so you assess voiding, measure urine output, and be prepared to manage catheterization if needed. Infection risk also exists with perioperative procedures, so monitor for fever, wound or catheter-site drainage, dysuria, or changes in urine. Because bulking injections can require repeat treatments and both procedures carry retention and infection risks, these post-op monitoring needs are common to both.

Thus, the best answer accurately describes the sling’s mechanical, supportive role and the bulking agents’ goal of increasing outlet resistance, and correctly notes the shared post-operative nursing considerations of activity restrictions and monitoring for urinary retention and infection.