Stress urinary incontinence is a symptom of involuntary leakage of urine during exercise, sneezing or coughing, i.e. activities that cause an increase in abdominal pressure. Initially, urine is lost during heavy physical effort, but gradually even walking causes urine to leak out. In the most severe forms, urine also leaks at rest.
There are two types of exercise NTM that often coexist:
anatomical (excessive movement of the bladder and urethra)
sphincter (weakening of the sphincter muscle of the coil)
Effort NTM occurs in one in seven women over the age of 20. Exercise urinary incontinence is caused by multiple births that cause direct damage to pelvic muscles, nerves or other structures supporting the reproductive system. There are co-morbidities that may increase the risk of stress urinary incontinence in a woman or worsen the course of an existing disease. These include genetic factors, obesity, constipation, smoking, urinary tract infections and neurological diseases.
There are three degrees of severity of stress urinary incontinence:
- Stage II — urinary incontinence caused by light physical activities (standing up, walking), — Stage III — involuntary leakage of urine also when lying down.
Stress urinary incontinence may be accompanied by forced urinary pressure and frequent small urination. The symptoms of this type of incontinence are more severe during the day than at night.
The most commonly used method of incontinence treatment is tape. The procedure is performed under general anaesthesia on an operating table resembling a gynaecological chair, under spinal anaesthesia. The procedure involves the insertion of a synthetic tape supporting the urethra through a small incision under the urethra in the vagina, either from apical access (TVT) or from the curtain access. The tape is introduced by means of specially shaped guides. During incontinence surgery with the TOT method we have a lower risk of bladder damage due to a slightly different method of tape placement than TVT. Over time, the tape overgives the tissues and stimulates local collagen production, thus supporting the urethra and preventing urine leakage. The procedure is performed by the vaginal tract, which means that the abdominal shells are not affected. The time of starting the patient after the procedure depends on the anaesthesia used. As a rule, the patient is started up about 6 hours after the procedure. After the procedure, the patient may drink fluids and begin to consume easily digestible food. The method is minimally invasive, the procedure is short and after it the woman does not have to stay in hospital for a long time.
The patient is discharged at home on the same day or the day after the procedure. Since the pain after the procedure is very slight, she only uses commonly available painkillers at home. After the procedure, you can return to your daily routine, and to full activity after about 4-6 weeks. If properly qualified for the operation, its effectiveness is estimated at 90%. For a few weeks after the operation, you can feel discomfort in the vaginal area, because secretion colored with blood appears.
In the postoperative period it is advisable to avoid physical effort, weightlifting, intensive sporting activities. If you catch a cold, ask your doctor about measures to stop the cough. The operated area heals for about 6 weeks and during this time you should refrain from intercourse so that the wound can finally heal. Most women experience a significant improvement in urine retention immediately after surgery. In others, it takes about 2 weeks for the effect to happen. It is worth taking care of the proper weight, avoid constipation, eliminate from the menu sharp spices, significant amounts of alcohol and coffee.