Stress urinary incontinence (SUI) is the most common form of urinary incontinence in women and is associated with high financial, social, and emotional costs.
Millions of women are effected by this and must face surgery.
This article discusses treatment options and potential complications from Stress Urinary Incontinence Surgery.
What is stress urinary incontinence? This is defined as a lack of bladder control due to the weakness of the pelvic muscles that help maintain the bladder sphincter tone.
It is also termed as the effort incontinence.
It is a predominant problem in the females and has an association with multiparity.
What are SUI treatment options? Usually the stress incontinence will be treated with non-surgical approach mainly aimed at behavioral change; however surgery is to be opted in case of the failure of non-surgical approach in relieving symptoms.
There are a few key points that the women should know about stress incontinence surgery in order to make it less of a problem and more of a success for them.
What are the risks of stress incontinence surgery? It is customary to make use of either sling procedures or colposuspension to treat this disease.
The use of these procedures is never without risks and so following information should be given to a patient will taking an informed consent.
1.
Bladder and bowel injury is the most common thing to happen during the procedure.
However it will be manifested only after the surgery if the surgeon hasn't noticed it per operatively.
This injury can lead to extravasations of the urinary and fecal matter into the lower abdomen making it a potential threat of peritonitis.
Apart from this, injury to the blood vessels can also occur making it inevitable to secure a good hemostasis vigilantly.
Fluid support might be needed to maintain the patient's hemodynamic stability.
2.
UTIs and wound infections are an important complication of the surgery.
Urinary tract infections are a frequent occurrence because of the fact that the periurethral area is colonized with bacteria that might gain entry into the wound and then travel upwards involving upper urinary tract.
This will give symptoms of fever, urinary frequency, and discharge from the wound site in the initial post operative days.
This has to be treated with antibiotics.
3.
Urinating problems like difficulty micturating and urge symptoms can develop in a few patients if the muscles have been strengthened a little too tight.
This is taken care of with physiotherapy and might sometimes need consideration of loosening the muscles a bit through surgery.
The latter option is however not usually employed.
4.
Rejection of the sling material by the body has a fair chance of happening if a synthetic material has been used.
The body tries to reject this material, foreign to it, by building up an immune response against it, further augmented by inflammatory and infective processes.
The sling will have to be removed surgically.
5.
Erosion of the surrounding structures like the uterus, bowel and the vagina can occur if the sling material is very reactive for the patient's body.
This leads to an extremely adverse side effect of fistulous connections between these organs and will lead further to more damage by the extravasations of waste matter through these structures.
It needs surgical correction.
6.
Anesthetic complications can take place during or after the procedure.
The use of certain inhaled anesthetics is related to the development of liver and kidney damage.
The functions of these organs should be monitored in the post operative period, should the liver or kidney failure develop.