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Bladder Suspension

Types of Bladder Suspension Surgery continued...

Sling surgery uses a piece of body tissue, called fascia, or a man-made material to create a sling or hammock-like structure that cradles the sagging bladder neck. This supports the bladder neck and urethra. You can use your own tissue for the surgery (if so, it is removed from your abdominal wall) or donated tissue.

You and your doctor will discuss which procedure is best for you. Your doctor will consider the following factors when choosing your procedure: Other health conditions you may have, the anatomy of your urinary tract and surrounding structures, and the surgeon's experience. Open retropubic suspension surgery and sling surgery require a hospital stay. The insertion of mesh slings to support the urethra can be done as an outpatient procedure.

Complications of Bladder Suspension Surgeries

All surgeries have risks. The most common complication after any type of retropubic suspension surgery is trouble urinating. Less than 5% of patients have permanent urinary retention. This may require urinary catheterization from time to time but rarely requires surgery.

Other complications associated with retropubic suspension surgery are rare but may include:

  • Abscess
  • Bladder spasms
  • Bleeding
  • Blood clots
  • Injury to the bladder, urethra, and other urinary tract structures
  • Infection (catheter-related infections are the most common)
  • Overactive bladder
  • Reactions to anesthesia
  • Vaginal prolapse

Complications associated with sling surgery may include:

  • Injury to the bladder, urethra, and other urinary tract structures
  • Infection (catheter-related infections are the most common)
  • Man-made sling material may wear away, leading to infection or reduced effectiveness
  • Reactions to anesthesia
  • Overactive bladder
  • Trouble urinating after the procedure
  • Painful intercourse

 

 

How Well Does Bladder Suspension Surgery Work?

Bladder suspension surgery works well to treat stress incontinence in most cases. Success rates for open retropubic suspension surgery range from 85%-90%. But, the effects do not last forever. Symptoms can return over time, usually after five years. Success rates also drop as the number of bladder suspension surgeries you have go up.

How successful the surgery is for you depends on:

  • Activities after surgery
  • How long you have had stress incontinence
  • Other surgeries and medical conditions you may have
  • Your age

The following can make bladder suspension surgery less effective:

  • A chronic cough
  • Low estrogen levels
  • Obesity
  • Older age
  • Poor nutrition
  • Radiation therapy
  • Strenuous activity

Reasons the surgery may not work may include:

  • You have a different type of incontinence (such as urge incontinence)
  • Problems with healing
  • Obesity
  • The surgical technique used

 

Recovery From Bladder Suspension Surgery

How fast you recover depends on the specific procedure. Open retropubic suspension surgery is done under general anesthesia, and requires a hospital stay. The surgery itself takes about one hour, but discomfort can last up to six weeks. Some sling procedures may be done under local anesthesia in an outpatient clinic. In general, recovery times are longer for procedures done through the abdomen, and shorter for those done through the vagina or via laparoscopic incisions.

Follow your doctor's instructions carefully after surgery. Avoid activities that put stress on the bladder and vaginal area. For example:

  • Do not use tampons or douches for 6 weeks
  • Avoid intercourse for 6 weeks
  • Do not strain during bowel movements
  • Avoid strenuous exercise
  • Do not do any heavy lifting

Remember, the most common reason surgery fails to improve symptoms is an incorrect diagnosis. That means, if you still have urinary leakage when you cough and sneeze after bladder suspension surgery, be sure to tell your doctor. You may have another medical condition causing the problem, and may need additional treatment or tests.

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WebMD Medical Reference

Reviewed by Melinda Ratini, DO, MS on July 18, 2014

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