Vitality Plus Urology specializes in both surgical and non-surgical treatment options for female stress urinary incontinence. Our expert urologists are skilled in urethral sling procedures, and can usually correct stress incontinence through surgery. The procedure will vary with the individual. To select the best treatment, your doctor will consider your medical history, the severity of your incontinence, anatomy and lifestyle. Your options may include sling procedures, vaginal and bladder suspensions, urethral injection of bulking agents, and artificial urinary sphincter placement.
A urethral sling is a tape-like mesh strip inserted through a ½ inch vaginal incision under the urethra. This creates a supportive sling for the urethra which stops urine leakage. It is recommended primarily for women who are finished having children, as the strain of childbirth would likely undo the device. This is an outpatient procedure which lasts around 20 minutes, and has shown very good results for the treatment of SUI – up to 80% cured, even years later.
Types of Urethral Sling Procedures
Suprapubic: The doctor makes a small incision inside the vagina just under the urethra. Two small openings – just large enough for a needle - are made above the pubic bone. The doctor places the sling inside the body. This requires no stitches to keep the sling in place, but the vaginal incision is often closed with a few absorbable stitches. The doctor may also need to seal the needle sites with sutures or skin glue.
Transobturator: This is a newer technique, it slightly modifies the suprapubic method. The doctor makes a similar vaginal incision, but the arms of the sling arms do not pass between the pubic bone and bladder. This reduces the risk of urethral and bladder injury.
Single incision mini-sling: This is the newest procedure based on the same concepts of the tension-free tape mid-urethral slings, but it only requires a single incision. This procedure often takes less than 10 minutes to perform in an outpatient setting and local anesthesia. It is generally considered to be as safe and effective as the previous methods but being new, its results are not as historically conclusive.
Lifestyle Changes
- Before or in conjunction with other treatment options, a specialist will often suggest lifestyle changes to help decrease bladder leakage.
- Manage your fluid intake: If you find that you experience bladder leakage at night or in the morning, reducing the amount of liquid before bed could help.
- Limiting caffeine and alcohol can also be beneficial.
- Lose weight: Carrying extra weight can have an impact on bladder leakage. You may benefit from losing even a small amount of weight.
- Physical Therapy: Going to see a pelvic floor physical therapist is the first step to creating a plan to strengthen your pelvic muscles. After performing an exam, the physical therapist will provide guidance on a treatment plan to help you regain pelvic floor function.
- Biofeedback: As pelvic muscles are hidden from view; it can be hard to determine if you are doing Kegels correctly. Biofeedback can be used to offer real-time feedback to show when you have targeted the correct muscles during physical therapy exercises, such as Kegels.
- Kegels: Kegels are an exercise you can do on your own to help strengthen your pelvic muscles.
- Pessary. A pessary is a small plastic device that is inserted into the vagina to help support the vaginal walls and provide lift to the bladder and urethra. Pessaries are available in a variety of sizes. Your provider will provide instructions on inserting and removing the device. To ensure you receive a pessary that is fitted correctly, it’s important to see a specialist who can provide guidance on what size is right for your body.
Medication Information
While there are [prescription] medications that can help reduce the symptoms of bladder leakage, medication currently only treats urinary Incontinence and overactive bladder. If you are suffering from mixed urinary incontinence (a combination of stress and urge incontinence), you may greatly benefit from using medication for urge incontinence. However, you may need additional treatments to decrease bladder leakage related to stress urinary incontinence.
FAQs: Stress Urinary Incontinence
Q. What is a stress incontinence surgery?
A. Stress incontinence surgery may be approached in different ways. In some cases, the surgeon may use your own tissue to correct your incontinence. Another minimally invasive option uses a synthetic or biologic material to help support your urethra, which is commonly known as a “sling.” It helps cradle the urethra by providing additional support to help correct urinary incontinence.
Q. What are the treatment options for stress urinary incontinence?
A. Treatment options for stress urinary incontinence range from the day-to-day management of symptoms to surgical treatments that provide a permanent solution.2 Examples of non-surgical options include wearing pads or absorbent undergarments or improving pelvic strength through muscle exercises. Find out more on non-surgical treatments at FemalePelvicSolutions.com. Surgical treatments include stress incontinence surgery that utilizes either your own tissue or a synthetic sling to support the urethra to help you regain bladder control. Your doctor can discuss these options to determine the best choice for you.
Q. Can I become incontinent again after having a stress incontinence surgery?
A. It is possible to become incontinent after stress incontinence surgery. One factor to consider is that future pregnancies following stress incontinence surgery may negate the effects of your surgery and you may once again become incontinent.
Q. What are the risks associated with stress incontinence surgery?
A. Some of the more common side effects from surgery include: mesh erosion, infection, short- or long-term pain, and injury to the bladder or other pelvic organs by the instruments used to place the sling. Ask your surgeon for a complete list of warnings, precautions and possible adverse events.
Q. How long does it take to recover from a stress incontinence surgery?
A. Every patient’s recovery time is different following surgery. During your recovery, be sure to avoid heavy lifting and sexual intercourse for six weeks or as recommended by your doctor. Your doctor will provide you with specific details about your recovery process.
If you are struggling with stress urinary incontinence, call Vitality Plus Urology to schedule an appointment with one of our expert urologists.