GYNECOLOGY:

 incontinence surgery

If other treatments aren't working, Saint John's offers several surgical procedures that have been developed to fix problems that cause urinary incontinence.

Surgical procedures include:

• Sling procedure. The most popular and common surgery for women with stress incontinence is the tension-free vaginal sling procedure. During this procedure, a surgeon places a strip of synthetic mesh under the urethra. The strip acts like a hammock, compressing the urethra to prevent leaks that occur with the activities of daily living.  This is an outpatient procedure, rarely requiring a catheter, and allows for rapid return to normal activity within one to two short weeks.

• Bulking material injections. Some women with stress incontinence benefit from bulking material injections. This procedure involves the injection of soft bulking materials into the tissue surrounding the urethra and helps tightens the seal of the sphincter by bulking up the surrounding tissue. The procedure is done with minimal anesthesia and typically takes about two to three minutes.

• Sacral nerve stimulator. This small device acts on nerves that control bladder and pelvic floor contractions. The device, which resembles a pacemaker, is implanted under the skin of the abdomen. A wire from the device is connected to a sacral nerve — an important nerve in bladder control that runs from the lower spinal cord to the bladder. Through the wire, the device emits electrical pulses that stimulate the nerve and help control the bladder.

• Bladder neck suspension. In this procedure, a surgeon makes an incision in the lower abdomen and then places stitches in the tissue near the bladder neck and secures the stitches to a ligament near the pubic bone or in the cartilage of the pubic bone itself. This has the effect of bolstering the urethra and bladder neck so that they don't sag.