Stress incontinence is one of the many causes of uncontrolled leaking of urine. Urethral suspension is a surgery to correct incontinence in women.
The incontinence is most often caused by weakening of the pelvic muscles that normally keep the bladder in position. The muscles may be weakened by:
The goal of this surgery is to provide extra support to the urethra and give more resistance against leakage. This will stop the uncontrolled leaking of urine.
Complications are rare, but no procedure is completely free of risk. If you are planning to have a urethral suspension, your doctor will review a list of possible complications which may include:
Your overall health will determine if you are at risk for complications. Talk to your doctor about any factors that may increase your risk.
Your doctor will try to find out why you are leaking urine through some or all of the following:
Leading up to surgery:
You may receive a spinal anesthetic to numb your lower body. General anesthesia may also be used, in which case you will be asleep.
Two incisions will be made in the vagina. A nylon mesh-like tape will be inserted in these incisions to form a hammock. This will give support to the urethra, closing the urethra during a cough or sneeze. No sutures will be needed to hold the tape in place. The mesh will hold onto the surrounding tissue until scar tissue grows into it.
After surgery, you will be monitored in a recovery room. You will most likely have a catheter in place to drain your urine.
1-1½ hours
Anesthesia will block pain during the surgery. After surgery, you may experience some pain or soreness. You will be given pain medicine to relieve discomfort.
You may be able to go home the same day.
At first, your urine may look bloody. This will resolve over time. When you are able to empty your bladder completely, the catheter will be removed. You may be up and walking the same day as the surgery.
Avoid lifting and strenuous exercise for six weeks after surgery. This will allow healing to take place.
To help ensure a smooth recovery, follow your doctor's instructions.
After you leave the hospital, contact your doctor if any of the following occurs:
RESOURCES:
National Kidney and Urologic Diseases Clearinghouse
http://kidney.niddk.nih.gov/
Urology Health.org
http://www.urologyhealth.org/
CANADIAN RESOURCES:
The Canadian Continence Foundation
http://www.continence-fdn.ca/
Canadian Urological Association
http://www.cua.org/
References:
Surgeries for female stress incontinence. US National Library of Medicine, Medline Plus website. Available at: http://www.nlm.nih.gov/medlineplus/print/ency/article/002992.htm. Updated May 2008. Accessed October 20, 2009.
The surgical management of female stress urinary incontinence. The American Urological Association website. Available at: http://www.auanet.org/content/guidelines-and-quality-care/clinical-guidelines/main-reports/fsuimainrpt.pdf. Published 1997. Accessed October 20, 2009.
Surgical management of urinary incontinence. American Urological Association website. Available at: http://www.urologyhealth.org/adult/index.cfm?cat=03&topic=133. Updated 2003. Accessed October 20, 2009.
Surgical mesh. US Food and Drug Administration website. Available at: http://www.fda.gov/MedicalDevices/Safety/AlertsandNotices/ucm142636.htm. Updated October 8, 2009. Accessed October 20, 2009.
Surgical treatment for female stress urinary incontinence. National Association for Continence website. Available at: http://www.nafc.org/bladder-bowel-health/types-of-incontinence/stress-incontinence/surgical-treatment-for-female-stress-urinary-incontinence/. Updated July 2009. Accessed October 20, 2009.
Treatment and prevention. The American Urogynecologic Society website. Available at: http://www.mypelvichealth.org/TreatmentPrevention/BladderControlProblems/TreatmentOptions/Surgery/tabid/120/Default.aspx. Accessed October 20, 2009.
Townsend MK, Danforth KN, Rosner B, Curhan GC, Resnick NM, Grodstein F. Physical activity and incident urinary incontinence in middle-aged women. J Urol. 2008;179:1012-1016; discussion 1016-1017.
Wein AJ. Campbell-Walsh Urology. 9th ed. Philadelphia, PA: Elsevier Saunders; 2007.
Last reviewed October 2009 by Adrienne Carmack, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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