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Pubo-Vaginal Sling Operation

Sling Operation for Incontinence

Pelvic health conditions that affect the vagina, uterus and bladder are very common. At least one third of all women in the United States will be treated for one or more pelvic health disorders by the age of 60. Two of the most common conditions are incontinence and pelvic organ prolapse.

Pelvic Organ Prolapse

Your vagina and uterus are secured to the pelvis by connective tissue that forms ligament-like structures around the vaginal walls. As pelvic floor muscles weaken, these connective structures give way, allowing the vagina to be displaced toward, and at times beyond, the vaginal opening.

The bladder above and the rectum below are thereby affected, leading to the following symptoms:

  • Loss of bladder and bowel control
  • Difficulty voiding
  • Urinary frequency (incontinence)
  • Problems with bowel movements, such as constipation and incomplete emptying
  • Feelings of pelvic or bladder heaviness, bulging fullness/pain or a feeling that something is dropping
  • Recurrent bladder infections
  • Discomfort or lack of sensation during intercourse
  • Back pain

While aging is a factor, there are many potential causes to pelvic organ prolapse. They include loss of muscle tone, estrogen loss associated with menopause, multiple vaginal deliveries, obesity, family history, pelvic trauma or previous surgery, repeated heavy lifting, and certain medical conditions such as diabetes.

Pelvic organ prolapse is diagnosed by a thorough pelvic examination. You may need diagnostic tests ordered such as a urodynamic study to evaluate bladder function or special image studies to visualize the bladder.

Treatment of pelvic organ prolapse may include the following:

  • Kegel exercises - Contracting and relaxing the pelvic floor muscles
  • Pessary - a device inserted into the vagina to help support the pelvic area
  • Pelvic Reconstructive Surgery - Pelvic Reconstructive surgery can be performed through the vagina or abdominally (via laparoscopy or traditional incision). During the procedure the surgeon will reposition the prolapsed organ(s) and secure them to the surrounding tissues and ligaments. Sometimes a synthetic material will be used to reinforce the repair. This procedure generally takes one to two hours and can be performed under regional (epidural or spinal) or general anesthesia. Many patients return to normal daily activity within three to four days. Most completely recover in a two to three week period. During this period there should be minimal interference with daily activities although you will have to avoid heavy lifting, strenuous exercise and intercourse for up to six to 12 weeks.

A complete physical examination and consultation with your urologist can determine which of the above treatments is right for you.

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