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Treatment for Urinary Incontinence

Retropubic Suspension and Sling Surgery
Most stress incontinence in women results from the bladder dropping down, which often occurs after childbirth. Two common surgical procedures for severe stress incontinence are retropubic suspension and sling surgery. These surgeries are usually performed in women, but can be done in men who are incontinent after removal of all or part of the prostate gland.
In retropubic suspension, the surgeon pulls the bladder up to a more normal position by sewing it to surrounding bone or tissue.
In sling surgery, the surgeon inserts a supportive strap of material (suburethral sling) to elevate the urethra and bladder neck, anchoring it to each side of the pubic bone. Slings are medical devices made from synthetic material, or they can be fashioned from donor tissue, or the patient's own tissue, which is cut from the abdominal wall.
Newer techniques for sling insertion are minimally invasive, allowing for smaller incisions and shorter hospital stays.
Like any surgery, retropubic suspension and sling surgeries all have their risks, including:
  • Infection
  • Injury to the bladder or urethra
  • Urinary retention.
None of these surgeries last a lifetime. Ten years of effectiveness is what most treatments attempt to accomplish. New symptoms may cause problems. As a woman ages and her body changes, pure stress incontinence may become urge incontinence.

Deciding How to Treat Urinary Incontinence

Experts agree that no urinary incontinence treatment is ideal for everyone with the condition. Your healthcare provider's recommendation will depend not only on the type and severity of incontinence, but on your lifestyle and personal preferences.
The success of treatment for urinary incontinence is an individual perception. Some people with stress incontinence and active lifestyles expect that success means no more pads. On the other hand, some people with severe incontinence of a complex nature who have failed multiple treatment options may be thrilled with 50 percent improvement of their bladder control.
It may not always be a reasonable expectation to be cured.
About 70 percent of women with incontinence problems benefit from a combination of simple measures, such as:
  • Bladder retraining
  • Exercises
  • Medication.
A combination of pads, medications, and exercise is effective for many men with incontinence problems.
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