Minimally-Invasive Surgery for Stress Incontinence

The MBUA doctors have extensive experience with minimally-invasive, outpatient surgery for stress incontinence, as well as more complex pelvic reconstructive surgery for women with stress incontinence and bladder prolapse. Our urologists have been at the forefront of surgical treatment of incontinence in women and can help women decide if this type of treatment is appropriate for them.

Introduction

Stress incontinence is caused by the bladder and urethra "dropping" into the vagina during a cough, sneeze, lifting, exercise or other activity. This stretches the urethral muscles so that they cannot keep the urethra closed, and a small amount of leakage occurs. The "dropping" of the bladder is caused by weakness of the support of the bladder which is more common after multiple childbirths or after menopause, but can occur in women of all ages. The most effective treatment for stress incontinence is surgery to support the urethra and bladder, which prevents them from "dropping" and prevents the stress incontinence. There are a number of different types of surgeries which have been developed over the years to treat stress incontinence. Abdominal surgery can be effective, but it is not often used unless patients require abdominal surgery for some other reason. Most women can be cured by surgery performed through the vagina, which allows for faster recovery and less pain than abdominal surgery. Within the past 5 years several "minimally-invasive" surgeries for stress incontinence have been developed which can be performed as an outpatient with less anesthesia and a high chance of long-term cure of stress incontinence.

Minimally-Invasive Surgeries

Minimally-invasive surgery for stress incontinence uses a strip of mesh that acts as a "sling" to hold the urethra and bladder in place during cough or sneeze. The operation involves a 3/4 inch incision in the vagina overlying the urethra through which the sling is placed. In the operation called SPARC two tiny incisions are made over the top of the pubic bone for passers which are used to pull the sling into place. In the operation called Monarc two similar incisions are made in the groin crease, one on each side, and a passer is used to pull the mesh into position. Both types of minimally-invasive surgeries take roughly 30 minutes to complete and can be performed with general anesthesia, spinal anesthesia, or local anesthesia and sedation. The risk of bleeding and infection is minimal, and most patients are back to normal living within a few days. The best thing is that 90% of women are dry immediately after the surgery and no longer have to wear pads or worry about stress incontinence. The MBUA doctors have extensive experience with this type of surgery for stress incontinence, as well as more complex pelvic reconstructive surgery for women with stress incontinence and bladder prolapse.