Urinary incontinence is a common problem in which a person experiences an involuntary loss of urine. Fortunately, it can often be treated effectively through surgery. With proper care and attention, you can regain control over your bladder and enjoy an improved quality of life.
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Urinary Incontinence (UI) refers to the inability to control urination or the loss of bladder control. This is a prevalent condition that can vary in severity from a minor inconvenience to a significant disruption to daily life. With appropriate treatment, however, UI can be effectively managed and improved.
There are several types of Urinary Incontinence, som of the most common are:
Stress urinary incontinence (SUI) occurs when a person loses control of their bladder when coughing, sneezing, lifting, or doing other athletic activities. All of these activities involve an increase in abdominal pressure, which can cause the leakage of urine.
True Stress Incontinence requires surgical repair. There are a number of different procedures which can cure this problem. These options will be discussed with the patient during the evaluation and examination. At that time, the best procedure for the patient’s particular problem will be chosen.
The second type of incontinence is called Urgency Incontinence. This occurs when urine leaks from the bladder without warning or provocation. Muscle tightening exercises (Kegels) and surgical intervention are not effective for this type of incontinence, in fact, they may make it worse. However, Urgency Incontinence may be treated with medication with excellent results.
The third type of incontinence is called Mixed Incontinence which is a combination of both Stress and Urgency Incontinence. The treatment for Mixed Incontinence may require a combination of surgery and post-operational medication.
There are several different surgical options for treating urinary incontinence, each with its own benefits and drawbacks. Some of the most commonly performed procedures include:
The sling procedure is typically performed on women with stress incontinence and can be done as an outpatient procedure. This technique involves placing a supportive sling made of synthetic material under the urethra to support it and prevent leakage.
The Bladder Neck Suspension technique involves the use of sutures or synthetic mesh to lift and support the bladder neck, which is the point where the bladder meets the urethra. This procedure is also typically performed on women with Stress Incontinence and can be done as an outpatient procedure.
The Transobturator Sling Procedure is another outpatient procedure used to treat women with Stress Incontinence. Similar to the Sling Procedure, the Transobturator Sling involves the placement of a synthetic sling through the obturator foramen, a small opening in the hip bone.
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The experience of urinary incontinence surgery will vary depending on the type of procedure you’re undergoing and your individual health history. In general, however, you can expect the following:
The Preoperative Evaluation involves a complete Medical history and Physical exam. During this examination, the doctor will determine the degree of prior vaginal trauma and the type of repair required to achieve the desired results.
All Lab work and reports will be sent to the surgeon for review prior to this meeting. Should a review of these reports indicate that there is a problem, the surgeon will reach out to discuss their concerns and formulate a plan with the involvement of the private Physician. This avoids the possibility of the patient having to undergo an unnecessary trip prior to a problem being corrected.
The need for use of a Laser for this procedure will be determined at this time.
On the day of surgery, the patient will arrive at the Surgical Center approximately one hour prior to their scheduled procedure. Our Board Certified Anesthesiologists will discuss the types of anesthesia available and if the patient has any allergies. An IV will be started, and once the patient is under anesthesia, they will be taken to the operating room.
The Urinary Incontinence procedure consists of incisions being made in the vaginal opening and the inside of the vagina. Of course, the patient will be asleep throughout the entire procedure. Incisions will be made at the bottom of the vaginal opening and along the bottom of the vaginal floor. Assuming this is the procedure that best will repair the problem.
Other procedures relieve Stress incontinence which consists of elevating the bladder either by performing a sling procedure or by making a small incision in the lower abdomen & elevating the bladder from above. The decision as to which procedure will best repair the existing problem will be determined at the time of the pre-operative examination.
Following surgery, the patient will be monitored for about one to one and a half hours. There will be no bandages to change or tubes in the bladder. Pain medication will be given in the recovery room if needed. However, this is not typically necessary immediately after surgery as the surgeon will the patient pain medication prior to them waking up from Anesthesia.
At discharge, non-narcotic oral pain medication is given to the patient. Patients typically have no problems urinating after the procedure. If the patient begins their menstrual cycle, tampons should be avoided until approximately 3-4 weeks after surgery.
We recommend daily showering. However, taking baths should be avoided for about two weeks. Full sexual function may be resumed approximately 3-4 weeks after the surgery
Dr.Richmond has an extensive educational and practice background. After completing his undergraduate training, he went to Pharmacy school, which prepared him for his goal, which was to complete Medical School with knowledge of Pharmaceutical treatment of disease. He completed an OB-GYN Residency at the University of Minnesota and soon afterward moved to Los Angeles, where he joined the staff of Cedars Sinai Medical Center.
Stress urinary incontinence can be caused by a variety of factors, including pregnancy and childbirth, menopause, aging, obesity, and neurological conditions.
Stress urinary incontinence is typically diagnosed through a physical exam and medical history review. Additional tests, such as a urine analysis, cystoscopy, or urodynamic testing, may be performed to rule out other conditions and determine the severity of the incontinence.
Non-surgical treatment options for stress urinary incontinence may include pelvic floor exercises, behavioral changes, medications, and medical devices, such as pessaries.
Stress urinary incontinence surgery is a type of surgical procedure that aims to improve urinary control by addressing the underlying cause of incontinence. There are several different surgical options available, including sling procedures and bladder neck suspension.
Generally, good candidates for stress urinary incontinence surgery are women who have not responded to non-surgical treatment options or have moderate to severe urinary incontinence that significantly impacts their quality of life.
Potential risks and complications of stress urinary incontinence surgery may include bleeding, infection, urinary retention, injury to surrounding organs or tissues, and failure to improve urinary incontinence.
The recovery process after stress urinary incontinence surgery can vary depending on the specific procedure performed. Generally, patients can expect to experience some discomfort, swelling, and bruising for several days to several weeks after surgery. Physical activity and sexual intercourse may need to be avoided for a period of time, as directed by the surgeon. Follow-up appointments will be necessary to monitor healing and ensure optimal results.
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