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Surgery and Other Treatments

Surgery and Other Treatments

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Updated July 08, 2009

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Surgery

Doctors usually suggest surgery to alleviate incontinence only after other treatments have been tried. Many surgical options have high rates of success.

Most stress incontinence results from the bladder dropping down toward the vagina. Therefore, common surgery for stress incontinence involves pulling the bladder up to a more normal position. Working through an incision in the vagina or abdomen, the surgeon raises the bladder and secures it with a string attached to muscle, ligament, or bone.

For severe cases of stress incontinence, the surgeon may secure the bladder with a wide sling. This not only holds up the bladder but also compresses the bottom of the bladder and the top of the urethra, further preventing leakage.

In rare cases, a surgeon implants an artificial sphincter, a doughnut-shaped sac that circles the urethra. A fluid fills and expands the sac, which squeezes the urethra closed. By pressing a valve implanted under the skin, you can cause the artificial sphincter to deflate. This removes pressure from the urethra, allowing urine from the bladder to pass.

Catheterization

If you are incontinent because your bladder never empties completely (overflow incontinence) or your bladder cannot empty because of poor muscle tone, past surgery, or spinal cord injury, you might use a catheter to empty your bladder. A catheter is a tube that you can learn to insert through the urethra into the bladder to drain urine. Catheters may be used once in a while or on a constant basis, in which case the tube connects to a bag that you can attach to your leg. If you use a long-term (or indwelling) catheter, you should watch for possible urinary tract infections.

Other Procedures

Many women manage urinary incontinence with pads that catch slight leakage during activities such as exercising. Also, you often can reduce incontinence by restricting certain liquids, such as coffee, tea, and alcohol.

Finally, many women who could be treated resort instead to wearing absorbent undergarments, or diapers--especially elderly women in nursing homes. This is unfortunate, because diapering can lead to diminished self-esteem, as well as skin irritation and sores. If you are an elderly woman, you and your family should discuss with your doctor the possible effectiveness of treatments such as timed voiding, pelvic muscle exercises, and electrical stimulation before resorting to absorbent pads or undergarments.

Points To Remember

  • Urinary incontinence is common in women.
  • All types of urinary incontinence can be treated.
  • Incontinence can be treated at all ages.
  • You need not be embarrassed by incontinence.

Additional Resources

American Uro-Gynecologic Society
401 North Michigan Avenue
Chicago, IL 60611-4267
(312) 644-6610

Continence Restored, Inc.
407 Strawberry Hill Avenue
Stamford, CT 06902
(203) 348-0601 or (914) 285-1470

National Association for Continence
(formerly Help for Incontinent People, Inc.)
P.O. Box 8310
Spartanburg, SC 29305
(800) BLADDER or (803) 579-7900

The Simon Foundation for Continence
P.O. Box 835
Wilmette, IL 60091
(800) 23-SIMON

Reprinted from the National Kidney and Urologic Diseases Information Clearinghouse

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