There are different types of urinary incontinence. The treatment recommended by your physician will depend on the type of incontinence you are determined to have. If your incontinence is due to an anatomical problem, your physician may recommend bladder surgery.
The urethra and the bladder neck are suspended by ligaments, which are tough bands of tissue. The strain of pregnancy and childbirth, and the decrease in estrogen in post-menopausal women can cause these support structures to weaken. If this support becomes relaxed, the bladder neck may drop below the pelvic floor. When this happens, the pressure increases that occur in the abdomen when you laugh or sneeze can be distributed unevenly, making the pressure in the bladder higher than the pressure in the urethral closure, which leads to involuntary urine loss.
Many different surgical procedures have been developed to elevate and support the bladder neck and urethra. Your surgeon will discuss with you the exact technique recommended in your case.
Depending on the specific anatomical problems, some patients will have their bladder surgery done through the vagina, while others will need abdominal incisions. The type of approach your surgeon recommends for you will be based upon the findings on physical exam, your general health, and previous surgeries.
Though you may still be very drowsy, you will wake up in the recovery room, where you will be closely monitored by nurses. After you have been recovered for about an hour, you will be moved to a patient room. You will have a catheter in place to empty the bladder of urine. If you have an abdominal incision, you will have a dressing over the site. You may have snug stockings on your legs to promote good circulation.
You will be asked to cough and breathe deeply to help keep your lungs clear and well-inflated. You will probably have some soreness in your lower abdominal area. Your surgeon will have prescribed the appropriate pain medication for you, so do not hesitate to let your nurse know if you are uncomfortable.
As with any major surgery, complications are possible with bladder surgery. Your surgeon will discuss with you the risks particular to your case, but generally they include blood clots in the veins, infections, bleeding, urinary retention, and problems related to anesthesia.
You will be given specific instructions when you are discharged from the hospital. You will be asked to make a follow-up appointment to see your physician in his office, usually within a couple of weeks of discharge. Some patients will be instructed to avoid driving, tub baths, swimming, douching and sexual intercourse until after they have seen their surgeon for their follow up visit. Some patients will go home with a urinary catheter in place. If you are sent home with a catheter, you will be taught how to care for it before your discharge from the hospital. Increase your activity level gradually and allow plenty of time for rest during your recuperation.
Call your surgeon immediately if: