Urinary incontinence, the involuntary loss of urine, is a more common condition than people may think. While it can affect people at any age, it is significantly more common in older people, and women are twice as likely to be affected than men. According to a study by Linh N. Tran and Yana Puckett, published in the National Library of Medicine, urinary incontinence affects about 13 million Americans.

Treatment options for incontinence would typically target the underlying cause and would initially involve lifestyle changes and exercise routines that focus on strengthening the pelvic area. Medications may be indicated for some patients depending on the underlying cause and severity of the condition. If these strategies do not substantially improve the condition, urinary incontinence surgery may be the only remaining solution.

Overview of Surgical Interventions

As the title suggests, this article focuses specifically on urinary incontinence surgery as a treatment option. We’re working on the premise that once surgery becomes the best or only option, you have already undergone extensive diagnostic tests and exhausted all the appropriate non-surgical therapy options without a satisfactory degree of success. We’ll discuss the causes, the diagnostic process, the prognosis and the impact on quality of life in a separate article.

The purpose of urinary incontinence surgery is to regain control over your bladder and preserve your quality of life by eliminating or substantially decreasing the frequency and severity of incontinence events. It’s important to understand, however, that surgery should only be considered where there is a severe disruption of daily activity, even after trying the less invasive treatments.

Types of Surgical Procedures

Tension-Free Vaginal Tape (TVT) Procedure

TVT (tension-free vaginal tape) surgery is a minimally invasive procedure that specifically targets stress incontinence in women. A synthetic mesh tape is placed under the mid-urethra to provide support. The tape is inserted through small incisions in the vaginal wall and lower abdomen, creating a sling that helps prevent urine leakage during activities that increase abdominal pressure, such as coughing or exercising. The procedure is typically performed under local or general anesthesia and has a high success rate, offering long-term relief with a relatively quick recovery time.

Sling Procedures

Similar to TVT, sling procedures use synthetic mesh or tissue placed in the body to create support around the urethra or bladder neck, which helps one to control urine flow.

Vaginal Mesh Surgery

Along the same lines, this also involves a mesh implant, just on a larger scale. The primary aim is to treat pelvic organ prolapse so the mesh supports the vaginal walls and pelvic organs.

Artificial Urinary Sphincter Implantation:

The artificial urinary sphincter implantation is a three-part device that takes over the function of the natural sphincter muscle. It consists of a cuff that encircles the urethra, a balloon reservoir placed in the abdomen, and a pump in the scrotum or labia. Compressing the pump directs urine to flow out, giving the user complete control and independence.

Colposuspension

Also known as bladder neck suspension, the procedure treats stress urinary incontinence by lifting and securing the bladder neck and urethra to a more anatomically correct position. The surgery can be conducted through laparoscopy, reducing pain, scarring, infection risk and recovery time.

Bulking Agent Injections

This minimally invasive treatment for stress incontinence involves injecting materials such as collagen, silicone, or carbon-coated beads into the tissues around the urethra. The materials add bulk to the urethral wall, allowing the urethra to close more tightly. The procedure is less invasive and provides a quick recovery compared to other methods, though the effects may be temporary, requiring repeat treatments.

Risks and Benefits of Surgery

The possible risks of urinary incontinence surgery include urinary tract infection or bleeding, reduced capacity to empty the bladder, and injury to organs near the operating area. Patients need to be educated about these and other potential long-term complications that may develop, like erosion of synthetic material and re-operation.

In many cases, symptoms improve dramatically after surgery. Depending on the procedure and the patient, success rates differ. According to a National Institutes of Health publication, procedures such as TVT and slings have success rates as high as 81% for severe urinary incontinence cases.

Preoperative Considerations

The first step in any surgical intervention is a preoperative evaluation, which includes a thorough review of the patient's medical history and a physical examination. Following this, patients will discuss anesthesia options with their healthcare provider to determine the best approach for their specific situation. They must also sign consent forms confirming they understand the procedure and associated risks and benefits.

Post-Operative Care and Recovery

Immediately following urinary incontinence surgery, patients are closely monitored to ensure vital signs are stable, manage pain and mitigate the risk of complications that may arise early in the recovery period. The patient may be kept in the hospital for a day or two, depending on the type of surgical procedure performed and the patient's overall condition.

Recovery times can vary widely depending on the type of surgery and the individual patient's health. Detailed post-operative care instructions and scheduled follow-up visits are vital to monitor progress and identify and address concerns as soon as they arise. Most patients can expect to return to their regular activities within a few days to a couple of weeks, with continuous improvement over time.

Long-term Expectations

Most patients experience a significant improvement or complete reversal of urinary incontinence symptoms. Patients often find they can resume normal activities, including exercise, social interactions, and work, without the constant fear of an embarrassing leak.

While many patients will benefit from the positive outcome for several years, some might experience a gradual decrease in effectiveness over time. A minority of patients may require further interventions or additional treatments, such as repeat surgeries or supplemental non-surgical therapies, if symptoms recur or persist.

Conclusion

All things considered, it’s pretty clear that urinary incontinence surgery may be the best long-term solution for people experiencing severe incontinence. However, because it is considered a last resort when all other therapies have failed, many people will choose to manage their condition through non-invasive therapies and lifestyle adjustments.

At LL Medico, we understand the impact urinary incontinence can have on those who opt to live with it. With nearly 30 years of expertise in senior care products, we provide not only a wide range of quality senior care products such as adult diapers, sanitary and skin care products and other incontinence management supplies but also support and guidance throughout this journey. Give us a call at (855) 422-4556 or email [email protected]. We’re here to assist you every step of the way.