UROGYANECOLOGY (URINARY INCONTINENCE & UTERO-VAGINAL PROLAPSE SURGERY)
- Many women leak small amounts of urine at times. These leaks can occur with certain physical activities such as laughing, sneezing or coughing. Others leak urine only while they are pregnant. When leaks become frequent or severe enough to be a problem, it is called stress urinary incontinence. This condition can be treated successfully by either physiotherapy or surgery.
- Some women feel the urge to urinate and cannot control it. This is called urge incontinence and can be managed effectively with medication.
- The tension free vaginal tape (TVT-O) obturator surgery is now the surgical treatment of choice for urinary incontinence. This surgery takes 10 to 15 minutes to perform and is done under regional or general anaesthesia. It is usually performed as a day surgery so patients can return home on the same day.
- Uterine prolapse means that the womb (uterus) has dropped from its position within the pelvis into the vagina. Normally, the womb is held in place by the muscles and ligaments that make up the pelvic floor. When the pelvic floor weakens, it is unable to provide adequate support for the womb and so the womb then descends into the vagina.
- Uterine prolapse most often affects postmenopausal women who had one or more vaginal deliveries. Damage to supportive tissues incurred during pregnancy and childbirth plus the effects of gravity, loss of estrogen and repeated straining can weaken pelvic floor muscles and result in a prolapse.
- In mild uterine prolapse, treatment is usually not needed. However when there is moderate or severe prolapse, a woman may experience the following symptoms:
– Sensation of heaviness or pulling in the pelvis
– Pain during intercourse
– Something protruding from the vagina
– Low back painIf the prolapse results in discomfort or interruption of lifestyle, surgery may be required to repair the prolapse.
- A cystocele occurs when there is a weakness of the tissue between the bladder and vagina resulting in the bladder bulging into the anterior vaginal wall. In mild cases, it can be managed conservatively but when it becomes symptomatic or the cystocele is severe, then surgical repair is warranted.
- In a rectocele, defect in the tissue between the rectum and the posterior vaginal wall leads to bulging of the rectum into the vagina. Mild rectoceles do not require surgery but if the rectocele worsens and becomes bothersome or increases in severity then surgery to repair the rectocele is usually the best form of treatment.
- We provide diagnostic tests and treatment for women with the following conditions:
– Urinary incontinence (involuntary leakage of urine)
– Overactive bladder (passing urine too frequently or having urinary urgency)
– Voiding dysfunction (difficulty in passing urine)
– Recurrent urinary tract infections
– Uterine prolapse, cystocele and rectocele (lump protruding out of the vagina)
– Other urinary symptoms eg pain when passing urine, blood in the urine, bed-wetting
- Urogynaecological surgeries that we perform in include vaginal hysterectomy, pelvic floor repair (with or without a mesh), tension-free vaginal tape, sacrospinous fixation, labiaplasty, vaginoplasty etc.