Urinary Incontinence, Stress: Treatment Options (cont.)

BONNIE:
Not to my knowledge.

MILLER:
The mesh is placed under the vaginal skin and is not felt by the partner during sex. In a rare number of patients, a very small amount of the mesh could be exposed, which would then be felt by the partner. This is easily correctable by having it trimmed.

MODERATOR:
What is the recovery time following surgery?

BONNIE:
The surgery was so easy, and two days later I was at an ice ring watching a competition. Dr. Miller, knowing I was an athlete, encouraged me not to do any physical activity for about 8 weeks, thinking I'd make it 6 weeks. But actually I am a coachable person and I listened to him. I waited all 8 weeks for my first run and to this day still have no problems.

MILLER:
For people without 5 gold medals, we generally recommend abstaining from heavy lifting or strenuous exercise for four weeks.

Miller: "The effects of pregnancy upon your bladder are out of your control."

MEMBER QUESTION:
I'm well acquainted with running to the bathroom all of the time while pregnant. But what is it about pregnancy that makes the problem continue after you give birth? And is there anything you can do when pregnant to prevent having this problem afterwards?

MILLER:
For the most part, the effects of pregnancy upon your bladder are out of your control. The nerves of the deep pelvis are stretched as the uterus and baby grow. These stretched nerves are often damaged and function less efficiently, leading to weak muscles and bladder symptoms. There is a theory that if you do pelvic floor exercises, possibly even Kegel exercises, while pregnant, you may help to minimize or delay these symptoms of incontinence.

MEMBER QUESTION:
Is being overweight a problem with this issue? It seems to me that excess weight would push on your bladder and make this worse.

MILLER:
I don't like to overly attribute incontinence to weight issues because it leads to an incorrect assumption of it being your fault. This is a problem of damage to the pelvic floor that is generally out of your control. However, it is noted that when overweight women lose weight their incontinence symptoms will often improve.

MODERATOR:
Is this nerve damage the reason you have to urinate so frequently while pregnant?

MILLER:
Surprisingly, no. Even though the symptoms during pregnancy and after are quite similar, their cause is different. During pregnancy the bladder is physically limited by the size of the uterus. You urinate often because you don't have room to fill your bladder.

After pregnancy it is the nerve damage and muscle weakness that results in those same symptoms, even after the compression of the bladder is relieved.

MEMBER QUESTION:
At what point do you advise a patient to have the surgery?

MILLER:
This surgery can be performed on any patient who is significantly bothered by incontinence. Any woman who's had to change her life, which includes the way she dresses, reduced sports activities, or avoiding being in situations where bathrooms are not close, will find this a significant detriment to their life and therefore qualify for the surgery.

MODERATOR:
Bonnie, you are obviously pleased with your decision to have the surgery.

BONNIE:
Yes, very much so. It was very easy and if I had to do it all over again, I wouldn't hesitate, but I don't have to, because I'm cured.

MODERATOR:
You are skating again but no longer competing, correct?

BONNIE:
I exercise. There's a difference between exercising and training and competing.

MODERATOR:
What kind of adjustments did you have to make before treatment?

BONNIE:
Wearing dark shorts; wearing bigger baggy t-shirts, wearing pads, changing your underwear and sometimes clothes more frequently. Before going on a run trying not to drink as much, not so much to dehydrate myself, but I definitely tried to cut back on liquids.

MODERATOR:
It must have been a relief to get back your life.

BONNIE:
Quite a relief, correct.

MEMBER QUESTION:
What kind of anesthesia is used in TVT surgery?

MILLER:
The anesthesia is variable and involves a discussion between the patient and doctor. It is very exciting that when desired, this procedure can be performed under local anesthesia. This avoids the nausea and dizziness associated with anesthetic medications. Regardless of the type of anesthesia, however, patients go home within three to four hours.



STAY INFORMED

Get the Latest health and medical information delivered direct to your inbox!