Stress Incontinence

STRESS INCONTINENCE

STRESS INCONTINENCE is the most common form of incontinence.

Childbirth and pregnancy can weaken the support of the urethra, tearing it away from its normal position and allowing rises in intra-abdominal pressure such as with coughing, sneezing and exertion, to cause a leakage of urine.

Treatment of this problem therefore needs to correct the supports of the urethra.

While this usually requires surgical correction, it is common to institute more conservative treatment with pelvic floor exercises before consideration of surgery.

Strengthening the pelvic floor muscle in this way may improve stress incontinence.

Other problems can cause similar symptoms so before consideration of surgical intervention, it is very important to ensure that it is the condition of stress incontinence not just the symptom.

Urodynamic studies MUST therefore be carried out before surgery—think first & cut later!

Traditionally, this surgery was achieved by a Colposuspension procedure and when done correctly [and this was unfortunately, not always the case] and for the correct condition, the success of this procedure was over 90%. This procedure has now been superseded.

The more recent advent of ‘tape’ procedures has provided a relatively easy alternative surgical procedure for those unskilled in a Colposuspension. With the added advantages of shorter hospital stay and faster recovery.

These procedures prevent further rotational urethral descent but do not restore the urethra to its retro-pubic procedure so one will expect a lower long term success

The disadvantages include

· Tape rejection and erosion

· Bladder perforation

· Haemorrhage

· Infection.

The development of the ‘Trans-obturator’ approach has already largely superseded the ‘retro-pubic’ tape procedures with less risk of bladder perforation pain and haemorrhage.

It is important to remember that surgery of any kind should NOT be undertaken without full urodynamic assessment by an appropriately trained person, and such surgery will not improve symptoms of urgency, or symptoms due to other disorders of micturition.

Phone: [08] 8332 1111

Fax: [08] 8332 5586

E-mail:

info@incontinence-sa.com.au

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Stress Incontinence

Overactive Detrusor

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