What is Stress Urinary Incontinence?
Urinary incontinence is defined as the involuntary leakage of urine. The problem afflicts approximately 13 million adults in the United States, 85% of them being women. There are many conditions that can cause loss of bladder control. Among women, the problem is most commonly associated with a specific condition called Stress Urinary Incontinence or SUI.
Stress urinary incontinence is the involuntary loss of urine during physical activity such as coughing, laughing, or lifting. The muscles that support the urethra (the small tube that carries urine out of the body) and bladder neck (the opening that connects the urethra to the bladder) have weakened, causing the urethra to drop during physical activity, resulting in urine leaking out of the body .
Conditions that cause Stress Urinary Incontinence
The first condition is called hypermobility. This occurs when the normal pelvic floor muscles can no longer provide the necessary support to the urethra and bladder neck. As a result, the bladder neck is free to drop when any downward pressure is applied and thus, involuntary leakage occurs.
The second condition is called intrinsic sphincter deficiency, usually called ISD. This medical term refers to the weakening of the urethral sphincter muscles or closing mechanism. As a result of this weakening, the sphincter does not function normally regardless of the position of the bladder neck or urethra.
How can a mid-urethral sling system help my incontinence?
A minimally invasive sling procedure using a mid-urethral sling system is designed to provide a ribbon of support under the urethra to prevent it from dropping during physical activity. The dropping of your urethra out of the correct anatomical position may be what causes your incontinence. Providing support that mimics the normal anatomy may prevent urine from leaking or reduce the amount of leakage.
What can I expect during my sling procedure?
Your sling procedure with a mid-urethral sling system will take an estimated 30-45 minutes. Your doctor will determine the type of anesthesia you will have during the procedure. Once the anesthesia takes effect, your doctor will begin the procedure. A small incision will be made in the vaginal area and two small incisions will be made through the skin in the groin area. Next, the synthetic mesh is placed. When it is placed, it will extend from one skin incision, in towards the vagina, around the urethra and back out though the second skin incision. This creates a “hammock” of support around the urethra. Your doctor will adjust the mesh tension so that the leakage of urine is reduced. When your doctor is satisfied with the position of the mesh, he or she will close and bandage the small incisions in the groin area and the top of the vaginal canal.