Operation for urinary leakage: everything you need to know about this surgery

Are you preparing to undergo surgery to treat an incontinence problem or are you wondering about an operation for urinary leakage? We tell you all about the variety of surgical options available.

Before any operation for urinary leakage: understanding urinary incontinence

By definition, urinary incontinence is an involuntary loss of urine, occurring outside of urination. This disorder can result from various causes and manifests itself in different ways depending on the individual. There are two main types of urinary incontinence:

  • Stress urinary incontinence (SUI), where urine leaks due to excessive pressure on the bladder, such as when sneezing, laughing or exercising.
  • Urge urinary incontinence , characterized by a sudden and compelling urge to urinate that leaves no time to reach the toilet.

These disorders can have a significant impact on quality of life, and it is therefore essential to understand their mechanisms to choose the best possible treatment, including surgical intervention and undergoing surgery for urinary leakage.

While waiting for incontinence surgery: anti-urinary leak pants?

THE Anti-urinary leakage panties - or more precisely support panties reducing urinary leakage - represent an interesting alternative to traditional protection for people suffering from incontinence .

When to consider surgery for urinary leakage?

operation for urinary leakage

Considering surgery to treat urinary incontinence is usually done when other treatments, such as perineal rehabilitation or drug treatment, are not sufficiently effective. It is also necessary to evaluate the type and cause of urinary leakage to determine if surgery is an appropriate option.

It is crucial to note that surgery is considered in the event of failure of other treatments and must be discussed on a case-by-case basis in a specialized urological consultation. Different surgical solutions exist to treat urinary incontinence, depending on the pathology.

For men, for example, surgery may be necessary if urinary incontinence is linked to prostate disease. In this case, it may be necessary to surgically remove the entire prostate or part of it.

In women, interventions such as colposuspension may be considered for stress urinary incontinence.

It is also essential to take into account that the duration of hospitalization following surgery for urinary incontinence is generally 24 to 48 hours.

Surgery for stress urinary incontinence: TVT and TOT

Principle of applying a suburethral sling

The placement of a suburethral sling is an operation commonly performed to treat stress urinary incontinence, when non-surgical treatments are not sufficiently effective . The principle of the operation is to support the urethra by placing a synthetic strip there, resembling a small polypropylene mesh. This strip is introduced through a short incision in the vagina and positioned without tension under the urethra.

Its role is to restore the initial position of the proximal part of the urethra and to provide anatomical support during efforts. This process helps prevent urinary leakage during efforts such as coughing , sneezing or during sporting activity.

There are two types of strips:

  • the TOT (Trans Obturator Tape)
  • and TVT (Tension Free Vaginal Tape), which differ in the technique used to implant them.

Duration and progress of the TVT or TOT operation

The TVT or TOT operation lasts on average between 15 and 35 minutes. It begins with the placement of a urinary catheter and general or partial anesthesia.

For the TVT, two small incisions are made in the suprapubic area , while for the TOT, the incisions are lateral, between the thigh and the vulva . In the case of TVT, a cystoscopy is performed to check the bladder.

The strip is then placed under the urethra through an incision in the anterior wall of the vagina. In some cases, the urinary catheter is left in place at the end of the procedure.

Anesthesia and preparation for surgery

General or regional anesthesia is commonly used for TVT or TOT operation. The decision between these two options depends on many factors, including the patient's overall health, surgeon preference, and the nature of the procedure.

As part of your urinary leakage operation, a pre-operative appointment with the anesthesiologist is generally scheduled at least 48 hours before the procedure.

To prepare for the procedure, it is recommended to stop smoking, as smoking can increase the risk of complications.

Also, washing with antibacterial soap can be done just before the operation to minimize the risk of infection. Finally, the patient is generally asked to arrive on an empty stomach on the morning of the procedure.

Aftermath of surgery and recovery after surgery for urinary incontinence

Length of hospitalization and sick leave

The length of hospital stay after surgery for urinary incontinence is generally brief, ranging from 24 to 48 hours. However, this duration may vary depending on the patient's state of health and the type of intervention performed.

As for work stoppage, it depends on the nature of the patient's professional activity. For sedentary work, a 10-day rest is generally necessary . On the other hand, for work requiring the carrying of heavy loads, the stoppage can extend up to 28 days.

It should be noted that post-operative precautions recommend avoiding significant efforts, such as carrying heavy loads or sporting activities, for at least one month. Finally, the duration of work stoppage after an operation for urinary leakage is set by the surgeon according to each specific case.

Managing post-operative outcomes at home after incontinence surgery

After an operation for urinary incontinence, certain precautions and actions are necessary at home to facilitate recovery and return to normal. First of all, you must respect the rest prescribed by the surgeon, and avoid significant physical exertion.

Furthermore, it is recommended to monitor the appearance of unusual symptoms such as severe pain, fever or abnormal bleeding, which could indicate complications.

  • Hygiene and diet : It is important to maintain good hygiene, especially around incision areas, to prevent infections. In addition, a balanced diet and good hydration promote healing and recovery.

  • Medications and analgesics : Taking medications prescribed by the doctor, including analgesics in case of pain, must be scrupulously respected.

  • Management of urinary leakage : It is possible that urinary leakage may persist after the operation. Specific protection for urinary incontinence can be used to improve daily comfort.

  • Post-operative consultation : A post-operative consultation is generally scheduled with the urologist to evaluate the result of the intervention and manage possible adverse effects.

It should be noted that post-operative management at home varies depending on each patient and the type of intervention performed.

Post-operative rehabilitation and medical monitoring

Post-operative rehabilitation is often necessary following surgery for urinary incontinence. This rehabilitation after incontinence surgery may include pelvic floor strengthening exercises, also called perineal rehabilitation, which aim to improve urinary control. These exercises can be done with the help of a healthcare professional, such as a physiotherapist or specialist midwife.

Post-operative medical monitoring is also a key element of recovery. During follow-up consultations, the doctor evaluates the effectiveness of the treatment by checking the reduction in the number of urinary leaks. If urinary leakage persists despite the operation, rehabilitation and drug treatment , further surgery may be considered.

Operation for urinary leakage: risks, complications and possible side effects

Urinary incontinence surgery is not without risks and can cause various complications and side effects.

These may include:

  • Damage to the operated sphincter or displacement of the urethra during the operation, which may lead to urinary leakage.
  • A wound in the bladder or urethra, generally exceptional, or hemorrhage .
  • A urinary tract infection or other types of infection, especially if there is a sore.
  • Post-operative pain .
  • Difficulty urinating after surgery, which may require additional catheterization.
  • Serious side effects after insertion of a suburethral sling, according to some patient reports.

It should also be noted that urinary incontinence may recur after the operation, particularly in the event of increased stress on the remaining sphincter or damage to the muscular tissues of the urinary sphincter.

Finally, psychological complications can arise, linked to the impacts of incontinence on quality of life.

Lifespan of the strip and possible need for reoperation

The lifespan of the strip inserted during an operation for urinary incontinence is generally quite long. In most cases, the strip can stay in place indefinitely. However, according to some medical sources, a lifespan of 10 years can be expected.

However, it should be noted that in certain exceptional cases, complications may arise, requiring reoperation. For example, bothersome chronic pain may require removal of a portion or the entire strip. In addition, hemorrhage or severe infection may occur in the days following the operation and require reoperation.

It is therefore crucial to maintain regular medical monitoring after the operation to quickly detect possible complications.

Testimonials and opinions from patients who have undergone surgery for urinary incontinence

The words of patients who have had the experience of an operation for urinary incontinence are a valuable source of information. Their testimonies allow us to understand the real experience of this intervention, its impacts on daily life and quality of life.

Elida, after 20 years of urinary leaks, returned to a normal life thanks to a simple operation. Pauline, following the placement of a strip, experienced a serious post-operative complication. There is also Richard, 66, who shares his journey with urinary incontinence following prostate cancer.

Varied experiences, which demonstrate the importance of each individual case in the face of illness.

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Quelle opération pour une fuite urinaire chez la femme ?

Plusieurs options chirurgicales peuvent être envisagées pour traiter les fuites urinaires chez la femme, en fonction du type et de la gravité de l'incontinence.

La pose d'une bandelette sous-urétrale (TOT ou TVT) est l'opération la plus couramment pratiquée pour l'incontinence urinaire d'effort. Cette intervention vise à soutenir l'urètre lors d'efforts physiques pour éviter les fuites.

La mise en place d'un sphincter artificiel est une autre option envisagée lorsque les muscles du sphincter sont insuffisants pour contrôler l'écoulement de l'urine.

La pose de ballons ajustables permet de renforcer le soutien de l'urètre et de contrôler les fuites urinaires.

Les injections péri-urétrales sont une autre solution pour les fuites urinaires d'effort, elles consistent à injecter un produit qui va gonfler les tissus et réduire les fuites.

Il est à noter que le choix de l'intervention dépend de plusieurs facteurs, comme la cause de l'incontinence, la sévérité des symptômes, et l'état de santé général de la patiente. Un suivi régulier post-opératoire est essentiel pour évaluer l'efficacité du traitement contre l'incontinence et détecter rapidement d'éventuelles complications.

Quelle opération pour éviter les fuites urinaires ?

Plusieurs types d'opérations peuvent être envisagés pour traiter les fuites urinaires. Outre la pose d'une bandelette sous-urétrale (TVT ou TOT), qui est l'opération la plus répandue, d'autres interventions peuvent être envisagées.

  • La mise en place d'un sphincter artificiel est une option si les muscles du sphincter sont insuffisants pour contrôler l'écoulement de l'urine.
  • L'opération de colposuspension, consistant à remonter la vessie et l'urètre à une position plus normale dans le bassin, peut également être proposée.
  • Dans certains cas, les injections péri-urétrales sont utilisées pour gonfler les tissus autour de l'urètre et réduire les fuites.

Chaque intervention a ses propres avantages et risques, et le choix dépendra de la cause et de la sévérité de l'incontinence, ainsi que de l'état de santé général du patient.

Quelle est la durée de vie d'une bandelette urinaire ?

La durée de vie d'une bandelette urinaire implantée lors d'une intervention chirurgicale pour l'incontinence urinaire est généralement bonne. De nombreux patients ne nécessitent pas de remplacement de bandelette tout au long de leur vie.

Toutefois, selon certaines sources médicales, une durée de vie de 10 ans peut être envisagée pour ces dispositifs. Il est important de noter que la bandelette peut parfois nécessiter un retrait ou un ajustement en raison de complications, bien que ces cas soient plutôt rares. Un suivi médical régulier est essentiel pour surveiller l'état de la bandelette et détecter rapidement d'éventuelles complications.

Comment se passe la pose d'une bandelette urinaire ?

La pose d'une bandelette urinaire est un processus chirurgical relativement simple et rapide, effectué sous anesthésie générale ou partielle. Le chirurgien commence par effectuer une petite incision dans la paroi du vagin et deux autres dans le creux de la cuisse. La bandelette, qui a l'aspect d'un tulle blanc, est ensuite passée par ces incisions, en remplacement des tissus défectueux.

C'est une opération qui se déroule sans ouverture de l'abdomen, ce qui réduit les risques de complications post-opératoires. Pour assurer un soutien optimal de l'urètre, la bandelette est réglée en demandant à la patiente de tousser ou de pousser, permettant ainsi de mettre la bandelette sous tension.

Un contrôle endoscopique (cystoscopie) est effectué pour vérifier l'état de la vessie après la pose de la bandelette.

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