Female Stress Urinary Incontinence
Stress urinary incontinence (SUI) refers to the leakage of urine with coughing, sneezing, or straining. It is very common, with almost 50% of all women experiencing some form of stress or mixed urinary incontinence in their lifetime. The prevalence increases with age, with women older than 50 being more likely to report SUI than younger women. Other risk factors for SUI include prior vaginal births, smoking history, obesity, and Caucasian race. Oftentimes, women who suffer from SUI rely on multiple pads or absorbable adult diapers to manage their symptoms. This can result in unwanted odors and skin breakdown.
Treatment of SUI
Initial conservative management of SUI involves practicing pelvic floor exercises, known as Kegel exercises. These are specific exercises women perform to strengthen the muscles of the pelvis that provide support to the bladder, urethra, rectum, and uterus. This can often be done in conjunction with a pelvic floor physical therapist. There are also a variety of inserts and pessaries that can be placed within the vagina and cause external stabilization of the urethra (tube through which urine passes from bladder to outside world) and decrease in incontinence.
There are currently no approved medications for the treatment of female SUI.
The primary treatment of SUI is surgical. Surgical treatments for SUI are classified as either urethral bulking agents, suspension procedures, or slings. Urethral bulking agents involve injection of compounds into or around the urethra to allow for better closure, thereby minimizing leakage. This is preferred in sicker patients who otherwise cannot undergo general anesthesia as the procedure can be performed under local anesthetic. It is not, however, the most durable or effective treatment option for SUI. Suspension procedures, such as the Burch suspension, is considered an abdominal surgery and may not be appropriate for women who have had multiple prior abdominal surgeries. It can, however, be performed minimally invasively with robotic surgery.
The most common surgical treatment for female SUI is the synthetic midurethral sling (MUS). This involves placement of a mesh sling as a supporting hammock underneath the midportion of the urethra. MUS surgery can be performed in an ambulatory setting, with women going home same day already peeing without leakage. Dr. Shirin Razdan completed a subspecialization in prosthetic surgery and has performed over 200 penile prosthesis and midurethral sling surgeries. She believes in providing her patients with compassionate and competent care to allow them to live their best lives without fear of embarrassing incontinence. If you or a loved one suffers from female stress urinary incontinence, call the office of Dr. Razdan to schedule an evaluation: 305-468-3314 . You can also complete the contact form and one of our schedule coordinators will get back to you as soon as possible to setup a consultation with Dr. Shirin Razdan.
FAQs
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What are potential complications of MUS surgery?
Because the sling is a foreign device, there is a risk of infection. Dr. Razdan will always check to make sure you do not have a UTI (Urinary Tract Infection) prior to performing this surgery. Other known risks include urinary retention, mesh perforation into the bladder or urethra, vaginal mesh exposure, and pelvic nerve pain. There is also a chance that the SUI does not improve after surgery.
Dr . Shirin Razdan is highly skilled and experienced in the field of robotic surgery, she offers procedures for a variety of conditions such as bladder, kidney, and prostate cancer. She has also successfully performed complex upper tract reconstruction procedures. Dr. Razdan performs prosthetic surgery for treating erectile dysfunction and stress urinary incontinence in males and females.