Incontinence

Stress urinary incontinence

Patients with involuntary loss of urine while coughing, sneezing, laughing, exercising, or during sex can have their stress urinary incontinence corrected.

There are two types of incontinence, but the most common type is SUI, Stress Urinary Incontinence.Have you ever leaked urine when coughing or sneezing, while dancing or doing other activities? Or, for no reason at all? If so, you are not alone. Bladder leakage - or stress urinary incontinence - affects millions of women.

Incontinence: am I a suitable candidate for surgery?

It is important to explore non-surgical avenues first.

Physiotherapy, in case of stress incontinence, may avert the need for surgical intervention. You are advised to discuss with your gynaecologist whether a pessary could could offer a solution.

Aging of the vagina can cause a myriad of complaints including stress incontinence. Your obstetrical history may play a very important role in the symptoms. Many complaints can be solved by non-surgical methods such as the famous Kegel exercise, designed to train the pelvic floor or vaginal muscles. If the Kegel exercises do not achieve the desired results then surgery can offer a solution. 

In a number of patients however SUI is the result of tissue looseness or trauma and a surgical procedure is the answer. Contra-indications for this procedure are: extreme obesity, smoker's cough, being too young and urinary complaints revealed during an urodynamic examination.

Incontinence: the procedure

Increasing vaginal muscle tone - Bladder lift
The surgery is designed to enhance vaginal tone, muscle strength and increase voluntary control. It tightens the vagina and strengthens the tissue of the pelvic floor between the vagina and the anus. It is usually necessary to perfom a bladder lift at the same time.

Laser - radiosurgical method

To avoid unnecessary bleeding we use state of the art surgical equipment like the Ellmann radiosurgical technique. Laser offers no added value, only the disadvantage of a higher price.

After surgery

We insert a catheter in the bladder for 24 hours to allow the bladder to rest and prevent any problems with healing.
You will be able to eat and drink right away because there is no effect on the digestive system.

After care

Our detailed aftercare plan will be discussed with you during your intake consultation and on the day after your surgery has been performed. Any operation can be emotionally draining and may deplete your physical reserves. You may feel down and tired the first few days. It is important, during the initial recovery period, to listen to your body  and to get enough rest.

• You should refrain from heavy lifting for 3 months.
• There will be some discharge (reddish-yellow) for 4-6 weeks.
• The following 6 weeks, until your last check up, you should refrain from vaginal and anal sexual intercourse.

Complications

Complications are rare, but can occur with any operation. The most common, specific to surgery for stress urinary incontinence are:

Cystitis
A bladder infection. We take the necessary precautions to prevent cystitis by prescribing antibiotics.

Problems emptying te bladder
Very rarely, when a bladder lift is performed, inadequate emptying of the bladder may occur temporarily. If this happens, we re-insert the catheter into the bladder and prescribe medication to encourage the voiding reflex.

Post-operative bleeding
Post-operative bleeding is very rare following vaginal surgery. Sometimes it may be necessary to insert a second vaginal tampon. A second operation, within the first 24 hours, is only rarely required to control pos-operative bleeding.

Hypertrophic scarring
Whenever surgical incisions are made, some form of scarring will occur. In the case of vulvar or vaginal surgery, scars tend to be negligible in all aspects. However, it always takes up to 18 months for the scar to heal definitively. During the healing phase, scarring peaks at 3 months and normally settles down after that. Exceptionally, scar tissue can develop into troublesome tissue, causing tenderness, pain or tightness. This condition of "scar hypertrophy" may require further surgery or other forms of treatment to help it.

Incontinence: long-term results

Please be assured that we do our utmost to avoid any possible complications.

Most patients are extremely happy with the results and wish they had the procedure much earlier. The regained vaginal muscle tone and improved bladder control, significantly improves their quality of life.

The result of this procedure may also contribute to increased sexual pleasure and well-being.