SUI is a type of urinary incontinence. With SUI, a woman leaks urine when she coughs, laughs, or sneezes or during certain activities, such as walking, running, or exercising.
SUI is a pelvic floor disorder. These disorders occur when tissues and muscles that support the urethra, bladder, uterus, or rectum are damaged. In SUI, the sphincter muscle that controls the urethra weakens, which may occur from pregnancy, childbirth, or aging.
Lifestyle changes, such as drinking less fluid, limiting caffeine, stopping smoking, and losing weight, can help decrease the number of times you leak urine. Other nonsurgical options include pelvic muscle exercises (Kegel exercises),physical therapy and biofeedback, or use of a pessary.
There are different types of surgery for SUI;
Urethral slings and colposuspension can be done through an incision in the abdomen (abdominal),through the vagina (vaginal),or with laparoscopy (laparoscopic). Injections can be given into the tissues around the urethra without an incision.
The type of surgery you have depends on many factors;
Before you have surgery, you should weigh all of the risks and benefits of your surgical options. Your health care provider can discuss these risks and benefits with you.
Synthetic materials are injected into the tissue around the urethra to provide support and to tighten the opening of the materials are injected into the tissue around the urethra to provide support and to tighten the opening of the bladder neck.
The procedure usually is performed in your health care provider’s office with local anesthesia. A lighted scope is inserted into the urethra and the material is injected through a thin needle. The procedure takes less than 20 minutes. It may take two to three or more injections to get the desired result. The injections may improve symptoms but usually do not result in a complete cure of incontinence.
There are two types of urethral slings that are used to treat SUI;
Midurethral sling surgery usually takes less than 30 minutes to perform. It is an outpatient procedure, meaning that you usually can go home the same day. Recovery time generally is quicker than with other procedures for SUI.
If synthetic mesh is used, there is a small risk (less than 5%) that the mesh will erode through the vaginal tissue. Infection, long-term pain, and other problems can occur with the use of synthetic mesh. Additional surgery may be needed to fix these problems. Another risk is possible injury to the bladder or other pelvic organs by the instruments used to place the midurethral sling. These injuries usually do not lead to long-term problems.
With traditional slings, there are none of the risks associated with synthetic mesh. However, this type of surgery requires more recovery time than midurethral sling surgery. You usually will need to stay in the hospital for a few days when having traditional sling surgery.
Risks of this type of surgery include urinary problems after the surgery, such as urgency or difficulty urinating. If these problems occur, the sling may need to be adjusted.
In colposuspension, the part of the urethra nearest to the bladder is restored to its normal position. The most common type of colposuspension performed is called the Burch procedure. The bladder neck is supported with a few stitches placed on either side of the urethra. These stitches keep the bladder neck in place and help support the urethra.
Colposuspension can be performed with an abdominal incision or with laparoscopy. When performed through an abdominal incision, the recovery time is similar to that of a traditional sling procedure. When performed by laparoscopy, you often can go home the same day. Risks include urinary problems after the surgery. The stitches may need to be loosened if this happens.
The following risks are associated with any type of surgery for SUI;
After surgery, discomfort may last for a few days or weeks. During this time, you may be told to avoid anything that puts stress on the surgical area, such as the following activities:
Some women may find it hard to urinate for a while or notice that they urinate more slowly than they did before surgery. They may need to use a catheter to empty their bladders a few times each day. In rare cases, if a woman is not able to void on her own, the stitches or the sling may need to be adjusted or removed.