Sling Procedures for Urinary Incontinence

Q:

Can you talk about bladder sling which is connected with Addison’s disease?

A:

What happens when a woman has stress urinary incontinence(SUI)?

With SUI, a woman leaks urine when she coughs, laughs, or sneezes or during certain activities, such as walking, running, or exercising. It’s because the sphincter muscle that controls the urethra weakens, which may occur from pregnancy, childbirth, aging, and occasionally Addison’s disease.

There’re nonsurgical treatment options for SUI, such as living a healthy lifestyle, and the well-known Kegel exercises. But some people may not respond to these treatment options. In this case, surgery will be a further option to consider.

Sling procedure is one of the main categories to treat SUI. The other one is bladder neck suspension procedures.

Tension-free sling

The tension-free sling is made from a strip of synthetic mesh tape. The material is compatible with body tissues. When surgeons place the tension-free sling, no stitches are used. Instead, body tissue holds the sling in place. Eventually scar tissue forms in and around the mesh to keep it from moving.
In tension-free sling, the doctor will make an incision in the vagina.

Surgical mesh usually is safe and effective. However, serious complications occur in some women, including erosion of the material, infection and pain.

Conventional sling

With a conventional approach, the surgeon makes an incision in the vagina and places a sling under the neck of the bladder. The sling can be made of synthetic mesh tape, or possibly your own tissue or tissue from an animal or deceased donor. Another incision is made on the abdomen. The surgeon pulls the sling to achieve the right amount of tension and attaches each end of the sling to pelvic tissue (fascia) or your abdominal wall using stitches.

Should you choose to use your own tissue?

Using a woman’s own tissue for sling material eliminates problems with rejection of the sling. It also reduces the risk of the wearing away (erosion) of the urethra or vagina. But using a woman’s own tissue increases surgery time and increases the number of incisions required. This is because the sling tissue must be taken from the woman’s body.

What to Expect?

Good news is that about 8 out of 10 women are cured after this surgery.

Your doctor may recommend two to four weeks of healing before returning to activities that include heavy lifting or strenuous exercise. It may be up to six weeks before you’re able to resume sexual activity.

You will probably feel some pain at the incision site and may feel some cramping in your abdomen if you take a traditional sling. Doctors will prescribe medicine to relieve your discomfort in the first few days.

Many women have some constipation after this surgery. Try taking more fiber, that should help. If it doesn’t, let your doctor know.

Risks of Surgery

Common surgery risks include bleeding, blood clots, infections.

The vaginal sling procedure also involves other specific risks, including

  • injury to or irritation around your vagina, bladder, or urethra
  • other changes in your vagina, such as a dropped or prolapsed vagina
  • development of a fistula, which is an abnormal connection or tunnel between your skin and vagina
  • overactive bladder or problems emptying your bladder

Childbirth or Not?

Think about your plans for having children. Your doctor might recommend waiting for surgery until you’re finished with childbearing. The strain of pregnancy and delivery on your bladder, urethra and supportive tissues might undo the benefits of a surgical fix.

UI & Addison’s Disease

Urinary incontinence is reported only by a few people with Addison’s disease by FDA though. One of the symptoms of Addison’s disease is weaken muscle. This can potentially cause UI. In the studies that I was able to find about UI and Addison’s disease, it shows co-existing conditions in women with Addison’s disease & UI. These conditions are:

  • Hypothyroidism
  • Diabetes
  • Bipolar Disorder
  • Migraine
  • Atrial Fibrillation/flutter

 

* The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.