Munson Health
 
Urethral Suspension -- Laparoscopic Bladder Suspension

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by Kellicker P
 

Definition

Stress incontinence is one of the many causes of uncontrolled leaking of urine. Urethral suspension is a surgery to correct incontinence in women.
The incontinence is most often caused by weakening of the pelvic muscles that normally keep the bladder in position. The muscles may be weakened by:
Female Bladder and Urethra
Bladder and uretha female
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What to Expect

Prior to Procedure

Your doctor will try to find out why you are leaking urine through some or all of the following:
Leading up to surgery:
  • Talk to your doctor about your medicines. You may be asked to stop taking some medicines up to one week before the procedure, like:
    • Aspirin or other anti-inflammatory drugs
    • Blood thinners, such as warfarin (Coumadin)
    • Clopidogrel (Plavix)
  • Arrange for a ride home from the hospital.
  • Do not eat or drink anything after midnight the night before.

Anesthesia

You may receive a spinal anesthetic to numb your lower body. General anesthesia may also be used, in which case you will be asleep.

Description of Procedure

This procedure uses 2-3 small incisions. Special instruments will be used to tie the bladder to the pelvic bone. A special scope is used to view the area during surgery.

Immediately After Procedure

After surgery, you will be monitored in a recovery room. You will most likely have a catheter in place to drain your urine.

How Long Will It Take?

1-1.5 hours

How Much Will It Hurt?

Anesthesia will block pain during the surgery. After surgery, you may experience some pain or soreness. You will be given pain medicine to relieve discomfort.

Average Hospital Stay

You may be sent home the same day if there are no complications.

Postoperative Care

At the Hospital
At first, your urine may look bloody. This will resolve over time. When you are able to empty your bladder completely, the catheter will be removed. You may be up and walking the same day as the surgery.
During your stay, the hospital staff will take steps to reduce your chance of infection such as:
  • Washing their hands
  • Wearing gloves or masks
  • Keeping your incisions covered
There are also steps you can take to reduce your chances of infection such as:
  • Washing your hands often and reminding visitors and healthcare providers to do the same
  • Reminding your healthcare providers to wear gloves or masks
  • Not allowing others to touch your incisions
At Home
Avoid lifting and strenuous exercise for six weeks after surgery. This will allow healing to take place. Ask your doctor about when it is safe to shower, bathe, or soak in water.
To help ensure a smooth recovery, follow your doctor's instructions.
 

RESOURCES

National Kidney and Urologic Diseases Information Clearinghouse
http://kidney.niddk.nih.gov

Urology Care Foundation
http://www.urologyhealth.org

 

CANADIAN RESOURCES

Canadian Continence Foundation
http://www.canadiancontinence.ca

Canadian Urological Association
http://www.cua.org

 

References


The surgical management of female stress urinary incontinence. The American Urological Association website. Available at: http://www.auanet.org/content/clinical-practice-guidelines/clinical-guidelines/archived-guidelines/fsuimainrpt.pdf. Published 1997. Accessed October 20, 2009.


Surgical management of urinary incontinence. American Urological Association website. Available at: http://www.urologyhealth.org/urology/index.cfm?article=33. Updated 2003. Accessed October 20, 2009.


Surgical mesh. US Food and Drug Administration website. Available at: http://www.augs.org/p/cm/ld/fid=163. Updated October 8, 2009. Accessed October 20, 2009.


Surgical treatment for female stress urinary incontinence. National Association for Continence website. Available at: http://www.nafc.org/bladder-bowel-health/types-of-incontinence/stress-incontinence/surgical-treatment-for-female-stress-urinary-incontinence/. Updated July 2009. Accessed October 20, 2009.


Treatment and prevention. The American Urogynecologic Society website. Available at: http://www.mypelvichealth.org/TreatmentPrevention/BladderControlProblems/TreatmentOptions/Surgery/tabid/120/Default.aspx. Accessed October 20, 2009.


Townsend MK, Danforth KN, et al. Physical activity and incident urinary incontinence in middle-aged women. J Urol. 2008;179:1012-1016; discussion 1016-1017.


6/3/2011 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Mills E, Eyawo O, Lockhart I, Kelly S, Wu P, Ebbert JO. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.e8.

 

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