Urinary incontinence (UI) is defined as the involuntary loss of urine. The condition affects approximately 20 million women in the United States. It is an embarrassing situation that many women don’t want to come forward and talk about, but there are plenty of treatments available. It is estimated that the average patient will wait 10 years before seeing a doctor. Unfortunately the most common treatment of choice is the use of sanitary pads. Healthcare providers know very little about the new advances and treatment choices that are available today. You deserve to know about your choices for treatment of even a drop of involuntary loss of urine in 21st century. A thorough evaluation and proper diagnosis of the condition is an important first step. There are many different types of urinary incontinence and coexisting conditions. They could each be handled differently using many new treatment choices available.
Burch Urethropexy (Laparoscopic)
Laparoscopic Burch urethropexy is a minimally invasive surgical treatment for stress urinary incontinence (SUI). During a Burch urethropexy ( elevation of urethra), sutures are placed around the bladder neck and proximal urethra on each side . These sutures are then attached to strong pelvic ligaments. Proximal urethra is suspended and supported by this method. Laparoscopic approach usually shortens postoperative recovery time and return to full function.
Also known as sacral nerve stimulation, InterStim® Therapy involves the use of an implantable device to help select patients with urinary retention or overactive bladder (OAB) to control bladder function. The InterStim® implant is inserted beneath the skin just above the tailbone. Using mild electrical pulses, the implant stimulates the sacral nerves, the nerves that control the muscles responsible for regulating bladder function.
Mini-Sling type procedures for Stress urinary incontinence
The most recent advancement in the treatment of stress urinary incontinence (SUI), the mini-sling is different from other sling procedures in that it usually requires the creation of only one incision. Unlike some other sling procedures, mini-sling placement does not involve a needle being passed through the groin. This reduces the risk of injury to the bladder or bowels and bleeding. During a brief, in-office or outpatient procedure the mini sling is placed through a very small incision in the vagina.
Suburethral Slings: Transvaginal ( TVT) and Transobturator (TOT) Sling
This usually refers to the insertion of a tension free tape underneath the urethra ( the tube that empties the bladder)to provide support. The tape is usually a synthetic non-absorbable thin mesh that is inserted through minimally invasive approaches. They are also referred to as tension-free vaginal tape ( TVT sling) or trans obturator or TOT sling. These kinds of procedures usually involve passage of special needles on each side of the urethra. Different anatomical approaches, techniques, and tapes ( grafts) are currently in use. The body grows into the mesh and provides a strong support for the mid segment of the urethra. Very good short and long-term results have been reported for this group of suburethral slings. It should be noted that this type of grafts and tapes are not among the ones that attorneys and lawyers have publicized as bad mesh, or failed transvaginal mesh insertion etc. This procedure in Dr. Bonni’s opinion has turned into a gold standard of treatment in women with stress type of urinary incontinence.
Dr. Bonni has performed close to 1000 of this type of slings with exceptional results often time using a short ( usually fifteen minutes or less) in office or outpatient procedure.
You deserve to know about your treatment choices to eliminate urinary incontinence. Please call us to schedule an appointment to see Dr. Bonni and tae advantage of the state of the art treatments offered in Orange and Los Angeles counties.