URINARY INCONTINENCE IN WOMEN

The placement of a tension free tape is the surgical procedure which is performed to treat female urinary stress incontinence (incontinence brought on by laughing, sneezing, lifting weights etc.).

Indications

This procedure is recommended for the treatment of female urinary stress incontinence which is not due to neurological conditions or to pelvic organ prolapse.

Preparation

On admission a pre-operative assessment is carried out which includes:

• Urine tests
• Blood tests
• Chest X-ray
• Cardiac assessment

In the event that a patient is on anticoagulant medication, it is necessary to stop taking this or to substitute it with an alternative, a few days prior to the surgical procedure.

How the placement of the tension free tape is performed

The procedure may be under general or epidural anesthesia.

First, the patient is placed in the position used for gynecological examinations, the area of the outer genitalia is antiseptically cleansed and a urinary catheter is placed.

The placement of the tension free tape is done through the anterior vaginal wall, with the aim of supporting the urethra and maintaining it in the correct position.

On completion of the procedure, the anterior vaginal wall is sutured, and vaginal gauze packing is placed.

On the following day, the catheter and vaginal gauze packing are removed.

The average hospital stay is 2 days.

After the procedure

During the first days after the procedure, there is a possibility that some discomfort will develop in the area of the urethra, these are mainly due to the presence of the catheter, and to bladder spasms lasting a few seconds.

These symptoms are treated with painkillers.

On removal of the urinary catheter, post-void residual urine volume (the amount remaining in the bladder after urination) is measured.

At discharge you will receive instructions on:

• The necessity of drinking plenty of fluids (around 1.5 liters per day)
• Avoiding drinking coffee or alcohol, as these can cause irritation
• Antibiotic medication which you should take
• How long to avoid lifting weights, strenuous physical exercise and intercourse
• Resuming any anticoagulant (blood-thinning medication) you may have been taking prior to the procedure

Most patients have no notable problems after the procedure.

Over two in every three women who have the procedure to place tension free tape have no incontinence afterwards, while one in three women have some leaking.