Stress urinary incontinence (SUI) is a significant health and quality-of-life concern for women in the United States. Stress incontinence that does not respond to behavior or exercise therapy is often treated surgically. There are several surgical options that are used to treat stress incontinence and these should be discussed with the patient to determine the best option. Such surgical options include:
This procedure is done through a small incision in the lower abdomen. The urethra and bladder neck are then elevated and restored to a higher anatomical position by suturing behind the pubic bone.
Patients with severe stress incontinence and weakened pelvic floor muscles may be good candidates for a sling procedure. A sling procedure can create urethral compression necessary to achieve bladder control. All appropriate non-surgical treatments should be tried before deciding on a surgical procedure.
Coloplast offers different kinds of slings to treat stress incontinence. Sling procedures have been done for over 90 years. Coloplast offers three techniques for sling placement, Transobturator, Suprapubic, and Pubovaginal.
Transobturator and Suprapubic slings, also called fixationless slings are used to treat incontinence by supporting the urethra. These are synthetic slings placed in a U-shaped or hammock position cradling the urethra and bladder neck. However, the sling is held in place through natural tissue ingrowth rather than screws or sutures. Coloplast Aris and Supris sling systems are examples of fixationless slings.
Another option is a pubovaginal sling. This procedure can also create enough compression on the urethra to help the patient retain bladder control. Historically, the pubovaginal sling was made from the patient’s own tissue. Today, Coloplast Suspend fascia lata and Axis dermis are natural and reliable cadaveric tissues for use in urethral sling procedures. This product offers a proven alternative to the use of the patient’s own tissue for a sling to suspend the urethra and bladder neck.
SUI, the brief involuntary leakage of urine on effort or exertion, such as when sneezing or coughing has two principal causes: urethral hypermobility and weakness of the urethral sphincter, known as intrinsic sphincter deficiency (ISD). Hypermobility and ISD coexist in the majority of SUI patients. For women with ISD, injection therapy- Durasphere EXP provides a relatively low risk and minimally invasive treatment option.
There are many different surgical procedures that may be used to treat stress incontinence, and the type of procedure will depend on the physician and the type and severity of the patient’s incontinence.