Stress urinary incontinence
OPERATIONSModern minimally invasive treatment of prolapse – lateral hysteropexy using the Dubuisson’s method. Stress urinary incontinence Tubal dropsy Vaginal surgery (vaginoplasty) Lowering of the reproductive system Infertility Uterine myoma Labia hypertrophy Ovarian cysts and ovarian tumors Endometriosis
Stress urinary incontinence is a symptom of unintentional leakage of urine during exercise, sneezing or coughing, or doing activities that cause an increase in abdomen pressure. Initially, urine is lost with high physical effort, but gradually walking causes its leak. In the heaviest forms, urine also leaks during rest.
There are two types of SUI that often coexist:
– anatomical (excessive bladder and urethral mobility)
– sphincter (weakening of the urethra sphincter muscle)
SUI occurs in every seventh woman over the age of 20 years. Stress urinary incontinence is caused by multiple births that cause direct damage of the pelvic muscles, nerves or damage to other structures supporting the reproductive system. There are co-factors that may increase the risk of stress incontinence in a woman or may worsen the course of an already existing illness. These include genetic factors, obesity, constipation, smoking, urinary tract infections and neurological diseases.
There are three levels of stress urinary incontinence that are distinguished:
- level I –leak of urine only under the influence of heavy effort (lifting, coughing),
- level II – leak of urine due to light physical activity (getting up, walking),
- level III – leak of urine also when laying down.
Stress urinary incontinence may be accompanied by compulsory urinary incontinence and frequent urination in small amounts. Symptoms of this type of incontinence are more intense during the day than by night.
Currently, the most commonly used method of treating urinary incontinence is a method with the use of tape. The treatment is performed under general anesthesia on an operating table resembling a gynecological chair under spinal anesthesia. The treatment consists of inserting a synthetic tape through a small incision under the urethra in the vagina supporting the urethra from retropubic access. The tapes are inserted through specially shaped guides. During operative treatment of urinary incontinence with the TOT method, we have a lower risk of bladder injury due to a slightly different method of placing the tape in relation to the TVT method. Over time, the tape exceeds the tissues and stimulates local collagen production, thereby supporting the urethra and preventing urine leakage. The treatment is done through the vagina, so without interfering in the abdominal wall.
The patient’s mobility after surgery depends on the anesthesia used. The patient is usually mobile about 6 hours after surgery. The patient may drink fluids and she may begin to eat easily digestible foods. The method is minimally invasive, the procedure lasts a short while, and after the procedure the woman does not have to stay in hospital for a long time. The patient is sent home the next day after surgery. Because pain after the surgery is very small, the only home remedies which are used are common analgesics. After surgery, you can return to your daily activities and to full activity after about 4-6 weeks. With proper qualification for surgery, its effectiveness is assessed at 90%.
For a few weeks after surgery, it is possible to experience discomfort in the vaginal area, due to the occurrence of bloody mucus. It is advisable to avoid physical activity, heavy lifting, intense sports activities during the postoperative period. If a cold occurs, ask your doctor for cough suppressants. The operated area heals for about 6 weeks and at this time, it is necessary to refrain from intercourse so that the wound after the surgery can heal entirely. Most women immediately after surgery experience a significant improvement in urinary retention. Others have to wait about 2 weeks for the effect. It is important to take care of proper weight, avoid constipation, eliminate spices, significant amounts of alcohol and coffee from the menu.