What are the most important surgeries for urinary incontinence or bedwetting?
Surgical treatment of urinary incontinence is one of the most important treatments for this disease, as it has a high success rate. Also, patient satisfaction with the surgery is over 90%
Important factors for a high success rate in urinary incontinence surgery:
The skill of the doctor with the surgery itself , and the selection of the appropriate operation
Using the latest methods of treatment
A lengthy conversation with the patient to find out her aspirations
The doctor's ability to treat other diseases that may be the cause of incontinence, or that increase the failure rate of the operation
The doctor's ability to initiate medical honesty, advising the patient what is necessary, and refraining from surgical treatment if it does not harm the patient's interest.
After prolonged discussion at the first visits, and making sure that the symptoms are often due to urinary incontinence due to the presence of weak urethral connections,
Dr. Qassem Shehab performs a cystography.
It is an examination of the function of the bladder, to confirm the clinical diagnosis, and also to ascertain the appropriate type of operation.
We insert a small ruler into the bladder and connect it to a machine that reads changes in bladder pressure, coinciding with the introduction of a physiological solution into the bladder, to simulate urine. We usually ask patients to have a full bladder. We seldom need an antibiotic for testing.
What urinary surgical treatments are available?
TVT retropubic-1 urethral lift tape
This is one of the most common operations. We rely on this tape to raise the urethra and reduce its movement during the increase in pressure on the pelvis.
The operation is generally short, and it takes no more than a day in the hospital. We insert the tape through a small vaginal incision under the bladder, not exceeding 2 cm.
Dr. Qassem Shehab prefers this operation to most operations in which tape is used, because of its high success rate. Of course, this process requires more skill, so we find that it is less common in Jordan and the Arab region in general.
Urethral lift tape TOT Ttansobturator-2
This is also a common operation in Jordan. We use a technique very similar to the above. However, the tape is extracted towards the upper incision of the thigh. Its success rate is also high, but perhaps lower than TVT. It may also cause long-term pain in the groin.
Bladder neck suspension. Burch colposuspension:
This is one of the first operations that was used for the purpose of treating urinary incontinence, and it is considered one of the most successful. However, due to the difficulty of the operation, and the need for an abdominal incision to be cursed by a cesarean section, and because of the presence of easier alternatives, as previously mentioned, we find this operation is likely to disappear. Be with the development of endoscopy, and the techniques to perform this operation laparoscopically, we find this operation still exists as one of the solutions. Dr. Qassem Shehab performs this operation in some cases that require this.
Bulking agents injections
We inject some substances into the urethra to help control urinary incontinence. We resort to this method if other previous operations have failed, or if there is a strong suspicion that there is a weakness in the urethral valve. This process is less effective than its predecessors, and in some cases it needs to be repeated after a period of two to three years.
Read also: bladder irritation.
Treatment of bedwetting in women
The final treatment is usually surgical, by raising the urethra to increase resistance
Treatment of bedwetting in women during sleep
If there is involuntary urination during sleep, you must see a doctor immediately, as it is possible that there are other diseases that lead to this disease
What is the reason for the causes of involuntary urination in women
In most cases in women, loosening of the bonds due to pregnancy and childbearing is the main factor in involuntary urination, but there are other reasons.
Symptoms of bedwetting in women
Urinary incontinence usually begins with involuntary dropping of urine (the woman does not feel the urge to urinate), and urine occurs when doing sports movements or carrying a heavy weight. Things may develop, such that the urine begins when coughing, laughing, or even sexual intercourse
Treatment of bedwetting in women during sleep
An item by minimizing liquids in the late night hours. Empty the bladder before sleeping. We can resort to some medications and be under the supervision of the doctor. It is important to make sure that there is no urine infection as a common cause of this urination
Dr. Qassem Shehab, consultant of advanced laparoscopic surgery, gynecology and obstetrics. Subspecialty specialization in the treatment of urinary incontinence and gynecological edema
Abdali Hospital, Boulevard, 24th floor
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