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Regain Bladder Control in 15 minutes--Urethral Sling for Stress Urinary Incontinence

Scott Landis KRAMER
Scott Landis KRAMER MD
California, Fremont
Obstetrics & Gynecology
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* Date : 09-07-2009 - 03:30 PM (4041 days ago),

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Dr. Kramer is the best! I am the world's worst wimp, and had really gotten myself worked up over a procedure. I went to Dr. Kramer as a new patient and he took the time to explain things to me, consulting both in the office and in the exam room. The procedure was a piece of cake - he was so gentle!

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Regain Bladder Control in 15 minutes--Urethral Sling for Stress Urinary Incontinence

You are reading this Special Report because someone you care about—yourself, a family member or friend—is coping with incontinence. It’s good that you are looking for more information. After all, leaving urinary incontinence untreated has a significant impact on health and quality of life, and speaking up is the first step to much-deserved treatment.

If you’re feeling uneasy about bringing this subject to light, it may help you to know that about 1 of 6 women over age 40 have incontinence, and about 1 of 3 women over age 65.

New Technology Generates Excitement
The past10 years have dramatically changed how doctors treat incontinence. Thanks to technology, more than ever there are promising treatments to remedy or even cure the condition. These advances have both doctors and patients excited.

“Slings have been around for 30 to 40 years, so they are not new,” explains Mona Alqulali, M.D., an obstetrician-gynecologist in Davenport, Iowa. “In the past, they required an abdominal incision and the use of a piece of fascia transplanted from the patient that was used to support the urethra, which is the canal that carries urine from the bladder. But because ligament strength can be genetically determined, the odds were good that the patient’s fascia would fail again re-creating the incontinence situation.”

Then came polypropylene mesh and its use in surgical procedures. Rather than cutting out piece of a patient’s fascia from another part of their body, a ribbon of this synthetic mesh placed under the urethra provided additional support and stopped the uncontrolled flow of urine. The use of surgical mesh dramatically changed the effectiveness of sling procedures. The mesh coupled with new surgical approaches to placing the slings is what has generated excitement within the field of gynecology. Today, incontinence treatment with a urethral support sling is a 15-minute, minimally invasive procedure that is performed vaginally through a single ½ inch incision. You are home and dry the same day.

Scott Kramer, M.D., a Gynecologist in Fremont, Calif., shares Dr. Alqulali’s enthusiasm. “Today, urethral support slings offer those with milder incontinence a less risky procedure and those with more severe leakage—including those who have experienced earlier failed procedures—a relatively safe and effective solution. Best of all most patients, young and old, return to regular activities in a few days.”

A Fast, Effective Procedure
After childbirth the urethra which was previously attached to the underside of the pubic bone may have torn supportive ligaments and sags. A urethral support sling helps correct incontinence with a ribbon of soft surgical mesh placed under the urethra. The mesh is made of loosely knit strands of polypropylene, or sometimes a biologic material. The mesh is light and porous so your body’s tissues can grow in and around it for increased support. Your urethra rests on the surgical mesh which recreates the support of the torn ligaments, thus preventing accidental leakage when pressure is put on the bladder like when coughing.

Placement of a urethral sling is a minimally invasive procedure performed on an outpatient basis Local, regional or general anesthesia can be used. You will return home in a few hours after the procedure is complete. Your doctor will advise you to refrain from heavy lifting for 2 weeks and form sexual intercourse for approximately four to six weeks.

Sling procedures require surgery and are not recommended for everyone, especially if you are pregnant, or have blood coagulation disorders, a compromised immune systems, renal insufficiency or upper urinary tract obstruction. Inflammation and irritation may occur after surgery. Future pregnancies may cause you to become incontinent again. You should talk with your doctor about benefits and risks before moving forward with any treatment option.

Moving Beyond Kegels
Your doctor should have recommended Kegel exercises as a way to strengthen your pelvic muscles. Do try these exercises to see if they provide you with results. How long should you continue with Kegels before looking to other treatments?

“Generally, if you have diligently performed Kegels for three months and not achieved a desired level of bladder control, it is reasonable to proceed with a urethral support sling,” says Dr. Kramer.

Real Results
Studies show that most patients demonstrate improvements in urinary incontinence following sling procedures. One study found more than 85% of patients remained dry or significantly improved even seven years afterwards and most women did not need any protection following the procedure.

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