Reviewed by Andrew Seibert on December 08, 2011

Sources

American Urogynecologic Society. American Foundation for Urologic Diseases. Cleveland Clinic. UrologyHealth.org. National Association for Continence. National Kidney and Urologic Diseases Information Clearinghouse. American Foundation for Urologic Diseases. New York Methodist Hospital.

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Video Transcript

Narrator: Urinary incontinence is an involuntary loss of urine. Your doctor may recommend surgery for this common problem if less invasive therapies fail to improve your symptoms. Your urinary system includes the kidneys, ureters, bladder, and urethra. Consisting of water and filtered waste, urine flows through the ureters to the urinary bladder, an expandable, muscular organ where urine is stored. During urination, urine leaves the body through the urethra. Special muscles at the base of the bladder, called sphincters, help control the release of urine by either relaxing to start the flow,or contracting to stop the flow. Most uncomplicated surgeries take about one hour and require spinal or general anesthesia. In an open abdominal bladder suspension, your surgeon will begin by making an incision in your abdomen, over your bladder. Your surgeon will then stitch the urethra and nearby bladder neck to the lining of the pelvic bone or other nearby structures. By changing the location and angle of the urethra, urine has less of a tendency to easily flow through under stress. As an alternative to open surgery, laparoscopic bladder suspension is sometimes performed. In a laparoscopic procedure, a lighted scope, camera, and small surgical instruments are inserted through tiny incisions in your abdomen. In a sling procedure, your surgeon will begin by making two small incisions— one in the vagina and one in the abdomen. The vaginal incision will expose the urethra and nearby bladder. The abdominal incision will expose a tough piece of tissue near the surface called the rectus fascia. Your surgeon will then attach one end of a sling, made of your own tissue or synthetic material, under the urethra and nearby bladder. He or she will attach the other end around the rectus fascia to form a hammock-like support for the urethra. At the end of your procedure, your doctor will stitch the incisions closed. Oftentimes, he or she will insert a catheter to help drain your bladder until you can easily urinate on your own. After your procedure, you will be taken to the recovery area for monitoring and given antibiotics and other medications as necessary. You will remain in the hospital for 1–3 days if you have an open bladder suspension procedure. If you have a laparoscopic procedure, you will most likely go home the same day as the surgery.