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Urinary Incontinence
SURGICAL MANAGEMENT
Sayantika Dhar
Sayantika Dhar
Sayantika Dhar
Contemporary
Pubo-vaginal sling Tension free vaginal tape (TVT) Trans-obturator tape (TOT)
Sayantika Dhar
Retropubic Colpo-suspension
Retropubic suspension surgery is used to treat urinary incontinence by lifting the sagging bladder neck and urethra that have dropped abnormally low in the pelvic area.
Sayantika Dhar
Retropubic Colpo-suspension
Sayantika Dhar
Sayantika Dhar
Sayantika Dhar
Sayantika Dhar
Sayantika Dhar
Sayantika Dhar
Sayantika Dhar
Pubo-vaginal Slings
The procedure involves placing a band of sling material directly under the bladder neck (ie, proximal urethra) or mid-urethra, which acts as a physical support to prevent bladder neck and urethral descent during physical activity.
Sayantika Dhar
Sayantika Dhar
Sayantika Dhar
Sayantika Dhar
Sayantika Dhar
Sayantika Dhar
Less invasive, Small incisions- Local anesthesia Same day or overnight surgery stay Return to work in 2 - 3 weeks
Sayantika Dhar
Sayantika Dhar
Complications:
Difficulty urinating and incomplete emptying of the bladder (urinary retention), although this is usually temporary Urinary tract infection Difficult or painful intercourse
Sayantika Dhar
Sayantika Dhar
Augmentation cystoplasty
Augmentation cystoplasty is the most often performed surgical procedure for severe urge incontinence. In this surgery, a segment of the bowel is added to the bladder to increase bladder size and allow the bladder to store more urine.
Sayantika Dhar
Augmentation cystoplasty
Contraindications Patients who are unable or unwilling to perform lifelong intermittent catheterization should not undergo augmentation cystoplasty because of the high likelihood of ultimately requiring catheterization. In addition, patients with inflammatory bowel disease, bladder tumors, or severe renal insufficiency should not undergo augmentation cystoplasty. Patients with a short life expectancy - consider alternatives such as continued medical management.
Sayantika Dhar
Sayantika Dhar
Urethral Bulking
Indications: Stress or Urge incontinence Poor or no response to conservative management
Sayantika Dhar
Aim of bulking
Build up the thickness of the wall of the urethra so it seals tightly when you hold back urine.
Sayantika Dhar
Performed under local anaesthesia Collagen used as bulking agent a skin test is done to check for allergies before the procedure
Sayantika Dhar
Risks:
pain at the injection site injury to the urethra, and Migration/ dislodging of the bulking material
Sayantika Dhar
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