Speak
With Your Doctor
The
information on this page is not intended to replace any
discussion with your doctor, or to replace any of the materials
he or she may give you. By taking the time to read this
patient guide, you've already taken an important step towards
correcting your incontinence and restoring the active lifestyle
you've always enjoyed.
With
new treatment options available for incontinence, women
can now restore, and may improve, their active lifestyle.
Urinary
incontinence affects over 13 million Americans, 85% of which
are women. While incontinence can be an aspect of aging,
it can be cured. With so many medical advances today, multiple
treatment options exist for patients, including surgical
correction.
The loss of voluntary control over your urinary functions
is called urinary incontinence. This guide has been developed
to educate you about female stress urinary incontinence
and to help you better understand your treatment options,
including surgical remedies. Although there are several
management and surgical options available, this patient
guide focuses on the Trans-obturator sling procedure, which
is a surgical correction for stress incontinence. Several
different types of slings are available. Your doctor will
be happy to discuss other options with you. Together, you
can determine the best treatment options for your specific
condition.
The
Urinary System
To
help you better understand incontinence, here is some basic
information about your urinary system. Your urinary system
is made up of:
 The
urinary system works with your brain and spinal cord to
coordinate urinary functions.
Your
kidneys filter blood and dispose of waste products in the
form of urine. Urine is carried out of the kidneys into
the ureters and into the bladder, which is a muscle-lined
bag that acts as a reservoir. Urine is stored in the bladder
until the brain sends a signal for it to empty. The bladder
is connected to the urethra by the bladder neck.
When
your urinary system is functioning normally, you can control
when to hold or release your urine. When your bladder becomes
full, it sends a signal to your brain, which then decides
if it's a convenient time to empty your bladder. If it is,
your brain will send a message to the bladder, and urine
will be released into the urethra. The urethral sphincter
muscle, which surrounds the urethra, opens and closes the
bladder neck. It will voluntarily contract to temporarily
hold urine, or release itself to let urine flow down the
urethra and out of your body.
Female
Stress Incontinence
Female
stress incontinence can develop slowly as you age, and may
often be a result of childbirth. It generally occurs when
your pelvic muscles are not strong enough to keep the opening
from the bladder neck closed when you're under physical
stress, which includes:
• Laughing
• Coughing
• Lifting
• Exercising
• Increasing abdominal pressure in any other way
Another type of stress incontinence is called intrinsic
sphincter deficiency. It occurs when the urethral sphincter,
which opens and closes the bladder neck opening, does not
function properly. Often, intrinsic sphincter deficiency
occurs in conjunction with female stress incontinence.
In addition to stress incontinence, there are other types
of incontinence, such as urge incontinence, and overflow
incontinence. Each is caused by a variety of conditions,
such as:
• Neurological diseases
• Birth defects
• Multiple sclerosis
• Spinal chord injury
• Pelvic surgery
Speak
with your doctor to learn more about the type of incontinence
you may have and your available treatment options.
Trans-obturator Sling
If
you have been diagnosed with female stress incontinence,
one surgical option your doctor may recommend is a Trans-obturator
sling procedure. A sling procedure corrects stress incontinence
by supporting your urethra to keep it in its correct position.
Currently, Trans-obturator sling procedures have a success
rate of about 85%. The operation is minimally invasive but
may require an overnight hospital stay.
Stress incontinence can occur when weak pelvic floor muscles,
or pressure from other organs, shift or weaken the bladder
neck. When the bladder neck is out of place, the urethral
sphincter may not be able to keep the bladder neck closed
under physical stress. The surgically implanted sling corrects
stress incontinence by supporting and repositioning the
bladder neck and urethra in their correct position—which
can help the urethral sphincter function properly. The end
result is that after a sling procedure, most women can once
again regain control of their bladder.
The sling "cradles" the urethra to prevent urinary
leakage.
 The
Surgery
During
a Trans-obturator sling procedure, your doctor will place
the center of the sling beneath your urethra. To place the
sling, an incision is made in your thigh and vagina. The
length of the incision will depend on the severity of your
condition and your doctor's approach.
When the sling is put in its desired position, it forms
a cradle around your urethra, which provides support. This
support holds the urethra in its correct position, which
corrects stress incontinence.
After the procedure, your doctor may recommend that you
use medication or other management products, but this will
depend upon the severity and type of your original incontinence.
Your doctor will discuss this with you in detail.
Choice
of Sling
Aris™
and ObTape® are synthetic slings that
provide support to your urethra
in the surgical treatment of stress incontinence. These
slings are made from a permanent biocompatible material
that promotes tissue ingrowth, which is essential to long-term
success. The Trans-obturator sling procedure is used with
both to ensure that there are no abdominal incisions. Your
physician will discuss which sling will work best.
It's important for you to know that following a sling procedure,
future pregnancies may negate the effects of the surgical
procedure, and you may once again become incontinent.
Your
Recovery
Although
every patient's process is different, there are general
recovery guidelines that apply to most Trans-obturator sling
procedures.
A Trans-obturator sling procedure is a minimally invasive
surgery; however, you may be required to stay in the hospital
overnight.
You also may experience some minor discomfort and fatigue
during the first 24 to 48 hours after your surgery.
You should be able to return to work and resume most of
your regular activities within four to six weeks.
During your recovery, it's important to avoid heavy lifting,
and sexual intercourse.
Your doctor will provide you with more specific details
about your individual recovery process, and he or she may
have other recommendations based on your individual needs.
Please follow your physician's directions closely. Even
though you may not be feeling any pain from your procedure,
you still have to let your body heal properly from the surgery
and to allow the sling material to incorporate within your
body's natural tissue. Should any problems occur after your
surgery, contact your physician immediately. This is especially
important if you have a high temperature, or if your surgical
area becomes excessively swollen, painful, red or inflamed.
Potential
Risks
Serious
complications from Trans-obturator sling surgery happen
infrequently. However, every surgical procedure carries
some risk. You may experience an increase in the need to
urinate or your urine flow may be slower. You may also not
be able to urinate naturally following the procedure. This
result may be temporary, but it may last a month or longer.
If this occurs, you may need to have a catheter inserted
to help you urinate, or you may need another operation.
You may have a reaction to the sling material itself. Another
potential complication is infection, which may require treatment
with antibiotics. You should ask your doctor to discuss
all these matters with you, as well as any other potential
risks and complications.
Insurance
Coverage
In
most cases, Medicare and insurance plans cover Trans-obturator
sling procedures. Consult with your insurance carrier before
seeing your physician to find out the specific criteria
for your coverage. The reimbursement specialist at your
doctor's office may be able to help you with this.
Returning
to an Active Lifestyle
There
are many options for treating or managing your incontinence.
It's important that you discuss your options with your doctor,
and gain an understanding of what each treatment might mean
for your future. By treating your incontinence successfully,
you can return to the active lifestyle you've always enjoyed.
If you would like more information about the Trans-obturator
sling device described in this brochure, please call (800)
525-8161 to speak with a patient education coordinator who
will be happy to answer your questions about stress incontinence
and its treatment options.
Questions
& Answers
What
is urinary incontinence?
Urinary incontinence is the loss of voluntary control over
your urinary functions. This condition affects over 13 million
Americans, 85% of which are women.
Can
urinary incontinence be successfully treated?
Yes. While incontinence can be an aspect of aging, it can
be cured.
What
causes female stress incontinence?
Female stress incontinence can slowly develop as you age,
and may be a result of childbirth. It generally occurs when
your pelvic muscles are not strong enough to keep the opening
from the bladder neck closed when you're under physical
stress, which includes laughing, coughing, lifting, exercising,
or increasing abdominal pressure in any other way.
What
are the treatment options for stress urinary incontinence?
Today there are multiple treatment options available for
patients, including a surgical correction called a Trans-obturator
sling procedure. Your doctor can discuss this and additional
treatment options with you.
What
is a Trans-obturator sling procedure?
A Trans-obturator sling procedure is a surgical option that
uses a simple hammock-shaped device to correct stress incontinence
by supporting your urethra to keep it in its correct position.
Can I become incontinent again after having a sling
procedure?
Currently, Trans-obturator sling procedures have a success
rate of about 85%. Therefore, it is possible to again become
incontinent following a sling procedure. In addition, future
pregnancies following a sling procedure may negate the effects
of your surgery, and you may once again become incontinent.
How
long does it take to recover from a sling procedure?
Every patient's recovery time is different. However, you
should be able to return to work and resume most of your
regular activities within four to six weeks. During your
recovery, it's important to avoid heavy lifting and sexual
intercourse. Your doctor will be able to provide you with
more specific details about your individual recovery process.
What
are the risks associated with a sling procedure?
While every surgical procedure carries some risk, serious
complications from sling surgery are infrequent. You may
experience some trouble with urination following the procedure,
from a slow flow to not being able to urinate, or you may
feel you have to go more often. You may have a reaction
to the sling material itself or an infection. Ask your doctor
for more information about potential risks and complications,
as well as your specific surgery and situation.
201
Mentor Drive
Santa Barbara, CA 93111 USA
(805) 879-6000
Customer Service: (800) 328-3863
Fax:(805)967-7108
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www.backincontrol.mentorcorp.com
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