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Stress incontinence

Stress incontinence in women

Stress incontinence is the leakage of urine during physical activities such as lifting weights, laughing, sneezing, coughing, and exercising. This type of incontinence is due to the weakening of the pelvic muscles.

When does it occur and what are the risk factors?

In most cases, it occurs after pregnancy, as a result of physical changes in the woman's body. Some of the risk factors can be the birth itself, with the pelvic floor muscles weakening, then the age where the bladder muscle weakens and its capacity decreases with age. Menopause, hysterectomy, some physical obstruction like urinary stone and certain neurological diseases like Multiple sclerosis and Parkinson's disease.

How is incontinence stress diagnosed?

In order to diagnose stress incontinence, it is necessary to perform a complete diagnosis.
  • History
  • Gynecological examination
  • Urine leakage that can be provoked by a doctor - will ask you to cough repeatedly
  • Ultrasound examination with measurement of urinary retention after urination
  • Cystoscopy - examination of the interior of the bladder with a stress test
  • Urodynamic testing - measurement of urinary bladder pressure and urinary flow

How is stress incotinence treated? 

Sling Procedure - Known worldwide as "strapping". It is an intervention in which a flexible mesh is placed as a support for the urethra, which enables the support of the urethra and returns it to its normal anatomical position. The operation is performed under general or regional anesthesia. The woman is placed in a gynecological position where surgery is performed. An incision is made in the vagina, on the front wall, which is about 2 cm in size, and through it is placed a synthetic band that wraps the bladder neck on both sides. The strap remains in the body and should not cause any problems.The threads fall out on their own and do not need to be removed by the surgeon. The incision on the vagina is not visible. An iodine gauze and a urinary catheter are inserted into the vagina, which will remain for one day. Antibiotics and painkillers are administered.The woman usually stays in the hospital one day after the intervention.Avoid heavy physical exertion 6 weeks after the intervention.After the surgery, it is possible to take a shower and do the usual daily activities.In most cases the woman is dry and neatly wet after two weeks.

What are the possible complications after the intervention? 

Poor reaction to anesthesia, bleeding, infection, bladder or urethral injuries. Frequent or urgent need for urination that goes away spontaneously up to about 3 months after surgery. Sometimes a part of the sling may pass through the wall of the vagina and cause discrete bleeding or discomfort during sexual intercourse. In this case, it is necessary to contact a gynecologist or urologist immediately. 

What does recovery look like after surgery? 

In case you cannot urinate due to swelling of the urethra, which is normal in some women, a new urinary catheter will be placed in the bladder and it will be removed after 4 days. In most cases you will be discharged the next day after removing the catheter and iodine gauze from the vagina. Research shows that over 90% of these interventions are successful.
 

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