Learn the Facts!
About four million women around the world are affected Urinary Incontinence. Coughing, sneezing, laughing, exercise or heavy lifting is often accompanied by involuntary leakage of urine(Urinary Stress Incontinence). It is commonly associated with aging but can also affect women of all ages.
However, it is important to know that these are common treatable conditions and you don’t have to live with it. There are many treatment options that can help you gain control over this condition. With proper medical care and treatment, you can regain your quality of life.
There are 2 methods of correcting urinary stress incontinence:
1) The non-surgical method
- Vaginal Pessary
- The Kegel Exercise is safe but would have to take 6 months until results would show, and does not guarantee full effectiveness.
- The incistionless Laser correction of Urinary stress incontinence.This is a new trend of innovation to the Cosmetic Gynecology, which is initiated. This method is suitable for the women with mild to moderate level of the symptoms or for those with some exitional diseases that cannot be treated by the method TVT-O technique.
2) The surgical method
- Surgery of the tissues near urethra adjacent to mons pubis bone.
- Urethral or Bladder neck injection by filler to avoid the premature opening of the urethra.
- The A-P Vaginal Repair can temporarily treat the urinary incontinence. Patients are likely to experience the symptom in 5 years after the surgery.
- TVT-O the minimally invasive procedure with an 85%- 90% success rate in treating Stress Urinary Incontinence.
General Notes & Precautions
1) Things about TVT-O you should know
- TVT-O is the newest and safest technique of surgical procedure for Urinary Stress Incontinence. It is an innovative, minimally invasive procedure with an 85%- 90% success rate in treating Stress Urinary Incontinence.
- The TVT–O technique is the surgery for the urinary incontinence caused by coughing, sneezing or lifting which lead to the prolapse of the anterior vaginal wall repair and of the urethra. The method TVT – O has limitations and cannot guarantee 100% success due to the fact that there are so many factors influencing the surgical’s sucess , especially for the patients with the Mixed Urinary Incontinence, such as those with overactive bladder, in need of continuous medications after TVT-O surgery.
- In case of unexpected surgical results or complications, corrective surgery is an option and will be discussed between the patient and the surgeon.
2) Before the procedure
- Before the procedure, Dr.Vitasna will conduct the background inquiry, general check-up and internal check-up for cervical cancer. The patient who have vaginal fungal or bacterial infection, she should completely treatment before the procedure to avoid the effect of wound healing process.
- However, it is not allowed for those with immunodeficiency, and the patient must not become pregnant nor plan to become pregnant in the next 3 months despite no research about the disadvantage to the pregnency and the newborn. In case of medical diseases or drug hypersensitivity, please inform the physician or the staff before the procedure.
- Dr.Vitasna will educate you the methods, processes of the procedure and some potential post-operative complications prior to decision-making.One of the most important preparations you should know is that you should take a still rest –refraining from work–for at least 2-3 days after the procedure to enable the wound healing and prevent the complication.In the first 1-2 weeks after the procedure refrain from some types of exercise affecting pelvic muscle movement, such as speed running, yoga, swimming, sit-up and sexual intercourse, for 6 weeks.
3) The cost of the operation
- The cost of the operation will include professional fees for the anesthesiologist and the surgeon, all the instruments, the home medications and medicine used for the procedure as well.
- However, fees for laboratory work-up for other existing diseases that the patient may have and the professional fees for the anesthesiologist and the surgeon for corrective surgery is not included in the package.
- With readiness, please call or e-mail us to confirm the date of surgery with Dr.Vitasna.
The Procedure and Post-Operative Processes
1) In the appointment day
- In the appointment day, you will be informed of the procedure details again. You may ask Dr.Vitasna for any additional information including consent forms and post-operative instruction form. In case of uncertainty, doubt, worry, or unconfidence for the reason of not informing relatives or husband of the procedure, you should postpone the procedure appointment.
- The patient has to refrain from drinking water or food for at least 6 hours prior to the surgery in order to decrease the risk of food remaining suffocation during or after the procedure.
2) About the procedure
- The surgery will be performed in our Operating Room for 30 minutes-1 hour under general anesthesia by our board-certified anesthesiologist.During the patient’s sleeping, Dr.Vitasna will begin to perform the surgery at the area of the anterior vaginal wall with the surgical wound length of about 1 cm.Then a special instrument will be used to insert the tension-free vaginal tape through the wound to bind (support) beneath the middle urethra, and the tape will be inserted outside via the Obturator Foramen to get outside both sides of your thigh (see illustration).
- This procedure is called “Tension- Free” because the slings are not sutured into the muscle, fascia or bone. Then the wound will be sutured with absorbable suture along the wound length. The patient needs to put a vagina pack in her vagina in 24 hours after the procedure to staunch the bleeding and needs to be urethral catheterized for one day.
3) After the procedure
- After the procedure, the patient will be monitored at recovery room for 1 hour. When the patient is conscious with normal vital sign, the anesthesiologist will allow her to be monitored in In-patient Building. Nausea and vomiting may be experienced by the patient, as a side effect of the general anesthesia, but which is noted to be relieved as soon as its effect wears off.
- In In-patient Building, the patient will take antibiotics, anti-inflammatory drug to lessen the wound pain, acetaminophen and laxative drug.In case of the patient have no recovery from the acetaminophen drug, she should inform the nurse to ask for the analgesic injection.
- Within the first day of the procedure, the patient should not take a shower–perhaps rub the body dry–; the patient is allowed to take a shower a day after the procedure or after the removal of the catheter.
- In the 1st-3rd days after the procedure, Dr.Vitasna will ensure that no abnormal bleeding occurs and the patient can have urination herself after the catheter removal, as well as the patient is asked to well review post-operative care. Then the physician will allow her to return home.
4) At home for post operative care
- For post-operative care, the patient must take antibiotics, anti-inflammatory drug to lessen the wound pain, acetaminophen and laxative drug , as prescribed by the physician, especially the antibiotics which should be wholly completed.
- Cleaning the surgical wound after urinary excretion may be done with sanitary wipes and after fecal excretion done using water and toweling gently.The patient should refrain from soaking in warm water, in bath tub or, swimming in the pool , weight training for lower parf of the body and sexual intercourse for 6 weeks after the surgery.
- The patient may experience light reddish bleeding out of the vagina in around 1-2 weeks after the surgery. A slim sanitary napkin should be used to monitor the post-operative bleeding. In case of a lot of bleeding or fresh reddish blood clot in the sanitary napkin , swollen reddish wound and high fever , please contact our center for suggestions or come to see Dr.Vitasna for the surgical wound examination.
The patient doesn’t needs to worry for disorders,complications are in a low rate.You may return to work within 3-5 days. There is no risk of sexual feeling .The patient should follow Dr.Vitasna appointment for examination or treatment in case of initial complications to avoid worsening.