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Women's Services: FAQs

Understanding Bladder Surgery

What is urinary incontinence?

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.

What are some anatomical problems that cause urinary incontinence?

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.

What can be done to repair these support structures?

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.

How do I prepare for bladder surgery?

  • Make a list of questions you would like to have answered by your physician before your surgery.
  • It is helpful to prepare and freeze some meals so that you will not have to worry about cooking during your first few days of recovery at home.
  • If you smoke, QUIT! Or at least stop for a week prior to surgery.
  • You may have some testing done, such as blood and urine tests, chest X-rays, or EKG.
  • You will be asked not to have anything to eat or drink after midnight the night before your surgery.

What should I bring to the hospital?

  • Pack a bag with robe, slippers, and toiletries.
  • The length of your hospital stay will depend on the exact type of surgery you have. Your surgeon will be able to tell you the expected length of your hospital stay.
  • Remember to bring your insurance card and a list of your medications to the hospital.
  • Do not bring any valuables to the hospital.
  • Bring eyeglasses, rather than contact lenses.
  • If you have dentures, wear them to the hospital.

What happens the day of surgery?

  • You will have an IV through which you may receive antibiotics to help prevent infection.
  • Your lower abdomen, pubis, and vulva may be shaved.
  • When you are taken to the operating room, your pre-op nurse will tell your loved ones where they may wait.

How will I feel after my bladder surgery?

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.

What are the risks of bladder surgery?

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.

Are there special instructions for when I go home?

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:

  • There is excessive bleeding from the vagina or the abdominal incision.
  • You have fever, or increasing pain, redness or oozing at the incision site.

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