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, giving 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.
This procedure will require one or two small incisions in the abdominal wall and vagina. The incisions will be made just above the pubic bone. A sling will be placed under the urethra. The sling will close the urethra when pushed down by a sneeze, cough, or other stressors. This will prevent incontinence. The sling can be made out of a synthetic material or tissue from your own body.
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 the discomfort.
You may be sent 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 on 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: chap 67.
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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