by Colette Bouchez
Although there are several types of surgeries for
stress incontinence they all have the same goal:
To provide something for the urethra to press
against, in order to help it remain closed
whenever pressure is applied - such as during a
sneeze, a laugh or a cough. This can be
accomplished n one of the following three ways:
Collagen Injections
Among the newest and most successful surgical treatments of incontinence involves collagen - the very same substance that dermataologists use to erase wrinkles and plump lips!
In this condition, however, the collagen - or occasionally another similar substance - is injected around the urethra to give it added support. It is most useful in women diagnosed with a type of stress incontinence known as "intrinsic sphincter deficiency". In this instance the muscle controlling the closing of the urethra no longer functions to its fullest, thus causing urine to leak.
The collagen injection works to narrow down the urethra opening so it closes more easily after urination. The injections take less than a half hour, and can be done in your doctor's office under light sedation. Recovery time is fairly quick, with most women back to normal activity within several days. Occasionally, you may need a series of shots administered about a month apart to achieve the full effect. You will also need a collagen allergy test at least once, if not twice, starting several weeks before each of your planned injections.
About 80% of women who try this surgery improve, and about 40% become completely dry. This procedure is not likely to help you if you have urge incontinence, if you have an abnormally small bladder, or if the neck of your bladder is not well supported. In addition, the effects of this injection last only about two years and then it must be repeated. However, newer, more long lasting materials are under development, and might be available in the near future, yielding a much longer-lasting effect.
Bladder Neck Suspension
In this procedure your doctor will make an incision into your lower abdomen and literally "lift" the tissue next to the neck of your bladder into a higher position, closer to the pubic bone. The tissue is stitched in place, thus creating a new system of support.
Recovery for this surgery takes a few days in the hospital and about six weeks at home. At least part of the time you may need to use a catheter to drain urine until healing takes place. In a slightly different version the operation is performed "laparascopically"- through one or more tiny incisions.
You can return home the same day and recovery is generally quicker. In still another version a tiny incision is made in your vagina and stitches are placed through the tissue supporting the urethra and then pulling them upwards, attaching them to a stronger layer of connective tissue. This also achieves the "lift" effect and offers the much needed support. Experts say this is the least effective of the three techniques.
Sling Procedures
During this surgery your doctor will insert a "sling" made of either your own tissue grafted from another site or a nylon synthetic "skin". It is placed underneath the urethra and then anchored to supporting ligaments, bones or connecting tissue on both sides. Acting as a kind of "hammock" of support, it gives added strength to the bladder neck and helps hold the urethra in the proper position. This, in turn, helps hold in urine during times of physiological stress. Recovery can take several weeks.
There are also several ways of performing this surgery. In the traditional procedure, the sling is inserted through a small incision in the vagina, attached on or into the pubic bone, and the ends are brought up and out through a tiny incision in the abdomen. In the newest version doctors use a "Tension-Free Vaginal Tape" to hold the urethra in place. As your body reacts to the tape, it creates a mesh of scar tissue around it, which further "cements" it in place and adds to the support. Faster and easier than the traditional surgery, this version can often be done under local anesthesia, and you can return to normal activities in about 10 days.
Either way, if the sling is pulled too tight during the surgery, it may block urine flow completely. If this happens you'll need a second surgery to correct the problem. In addition, while this operation can be helpful for stress incontinence, at the same time it can actually cause "urge" incontinence to develop. This however, can often be controlled with medication.
Artificial Sphincter
This treatment involves surgically implanting a fluid-filled cuff around the urethra to prevent urine leakage. The compression involved helps keep the urethra shut, so no urine can actually pass. In order to urinate, a small pump is implanted into the lips of your vulva, which you squeeze. When you do, the fluid drains from the cuff into a storage balloon, which is implanted in your abdomen. This releases pressure on the urethra and allows urine to flow. Within a few minutes the fluid returns to the cuff and tightens the urethra -much the way you might screw on the lid of a jar.
The whole procedure takes about two hours under general anesthesia, and requires three incisions. Recovery time is several days of hospitalization and 4 to 6 weeks at home, during which time the pump is not yet activated. This surgery carries a risk of infection, erosion around the implants, and a moderate degree of "equipment failure" - all requiring additional surgery to correct. This complex procedure is generally only used in women with severe stress incontinence due to intrinsic sphincter deficiency, who fail to find help using any other option.
To learn more about surgeries for urge incontinence, click here:
To learn more about how to tell the kind of bladder control problems
you have - and learn the secrets of self-help click here.
To discover . . .
- How to know what type of incontinence you have
- The best new medications for bladder control
- The newest self-help methods that really work
- How and why bladder controls falters - and what to do
- The most important news about mid-life UTIs
- Learn about bladder prolapse- and what you can do
PLUS :
- The truth about HRT - right now!
- How and why hormones change
- Hot Flashes & Mood Swings:What You Can Do
- Night Sweats: Why they Happen
- Dysfunctional Bleeding-What To Expect
- Irregular Periods: What They Mean
- How Mid-Life Skin Changes - and age-defying make up tricks
- How To Look Younger Without Surgery
- Female Sex Products That Really Work
- Natural Hormones: The REAL Truth
- How Mother Nature CAN Help
- How Exercise Can Change Your Sex Life
AND SO MUCH MORE . . .
If these are the questions on your mind
then you need . . . .
Your Perfectly Pampered Menopause
The book that really understands how you feel -
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Women & Stress Incontinence - Your Treatment Options
Are you plagued with stress incontinence? Have medications failed you? Then it might be time to consider incotinence surgery. Here are some options.
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