What is stress incontinence?
Stress incontinence is when urine leaks from your bladder. It usually happens when you do things that place pressure (stress) on your bladder such as exercising, laughing, coughing and sneezing.
Having weak pelvic-floor muscles is a common cause of stress incontinence. The weakness is usually caused by the muscles being stretched or damaged during childbirth.
Sometimes stress incontinence can be caused or made worse by a weakness in the urinary sphincter. The problem is often made worse if you smoke, are overweight, have constipation or a cough and tends to get worse with age.
What are the benefits of surgery?
Urine should no longer leak from your bladder in an uncontrolled way.
Are there any alternatives to inserting a TVT?
Having a transobturator tape inserted is a similar operation to inserting a TVT but the tape comes up out of your thigh crease instead of behind your pubic bone.
Simple treatments include pelvic-floor exercises, electrical stimulation, incontinence devices and bladder-neck bulking.
There are other surgical procedures such as Burch colposuspension, needle suspension and having a sling inserted. These are larger operations than inserting a TVT but are usually no more effective.
What does the operation involve?
The operation is usually performed under a general anaesthetic. The operation usually takes about 30 minutes.
Your doctor will make two small cuts on the lower part of your abdomen and another small cut on your vagina just below your urethra (tube that carries urine from your bladder) (see figure 1).
They will pass a needle, with the tape, from one side of your urethra and up through one of the cuts made on your abdomen. Your doctor will pass the needle, with the tape, from the other side of your urethra and up through the other cut on your abdomen.
What complications can happen?
1 General complications
- Feeling or being sick
- Developing a haematoma
- Infection of the surgical site (wound)
- Unsightly scarring
- Blood clots
2 Specific complications
- Urine infection
- Damage to your bladder
- Difficulty passing urine
- Damage to surrounding structures
- Overactive bladder
How soon will I recover?
You should be allowed home after you have passed urine in the normal way, usually later on the same day or the day after.
You may be able to return to work after three to four days, depending on your type of work. However, most women need to wait two to four weeks.
Your doctor may tell you not to do any manual work for a while. Do not lift anything heavy for a few weeks.
Regular exercise should help you to return to normal activities as soon as possible. Before you start exercising, ask the healthcare team or your GP for advice.
Continue your pelvic-floor exercises to prevent the incontinence from coming back and reduce the risk of a prolapse.
Inserting a tension-free vaginal tape should prevent you from passing urine in an uncontrolled way.
Author: Dr Caroline Dowling MS FRACS (Urol)
Illustrations: Medical Illustration Copyright © Nucleus Medical Art. All rights reserved. www.nucleusinc.com
This document is intended for information purposes only and should not replace advice that your relevant health professional would give you.