Gynaecology

Gynaecology

Urinary Incontinence & Uterine Prolapse

Urinary Incontinence Treatment & Surgery

Urinary Incontinence is the involuntary leakage of urine. In stress urinary incontinence, these leaks occur with certain physical activities such as laughing, sneezing or coughing. Others leak urine only while they are pregnant, after childbirth and menopause. It occurs when the bladder sphincter muscles become too weak to withhold the urine. These leaks can become frequent or severe enough to be a problem and can be treated successfully with either physiotherapy or surgery.

Some women feel the urge to urinate and cannot control it. This is called urge incontinence and is caused by overactive involuntary contractions of the bladder muscles and this can be managed effectively with medication.

Treatment

The tension-free vaginal tape (TVT-O) obturator surgery is now the surgical treatment of choice for stress urinary incontinence. This surgery takes 15 minutes to perform and is done under regional or general anesthesia. It is usually performed as a day surgery so patients can return home on the same day.

Tension-free vaginal tape (TVT-O) obturator system for Urinary Stress Incontinence

Utero-vaginal Prolapse,
Cystocele & Rectocele Treatment & Surgery

Uterine Prolapse is the condition where the pelvic floor muscles become too weak to support the uterus, resulting in the uterus descending into the vagina. It mostly affects women whose pelvic tissues have weakened because of childbirth and menopause. The loss of estrogen and repeated straining of the pelvis eventually result in a prolapse. Treatment is usually not needed for mild cases. However, when the condition is more severe and lifestyle is affected, surgical repair will be required.

Symptoms

  • Sensation of heaviness or pulling in the pelvis
  • Vaginal laxity and decreased vaginal tone during intercourse
  • Urinary leakage, retention of urine or bladder infections
  • Difficulties with bowel movement
  • Abnormal protrusion from the vagina
  • Lower back pain

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.

Treatment

Both urinary incontinence and uterine prolapse can bring about distress and interruption of lifestyle. Depending on the severity, these conditions can be treated through surgery or non-surgically.

  • Ring Pessary
    For patients who are unfit for surgery, a ring pessary can be fitted into the vagina to support the pelvic floor tissue. This pessary has to be changed regularly every few months. Kegel exercises, also known as pelvic floor exercises, can be done to strengthen the muscles around the area.
  • Urogynaecological surgeries that we perform to treat uterine prolapse, cystoceles and rectoceles include vaginal hysterectomy, pelvic floor repair (with or without a mesh), sacrospinous fixation and sacrocolpopexy.

In addition, we also provide diagnostic tests and treatment for women with other related conditions like overactive bladder (passing urine too frequently), voiding dysfunction (difficulty in passing urine), recurrent urinary tract infections and other urinary symptoms e.g. pain when passing urine, blood in the urine, bed-wetting.

Vaginal laxity and gaping vagina

Some women, as a result of difficult vaginal deliveries and/or menopause, develop lax vaginas and gaping introitus (vaginal opening). They may start to complain of decreased vaginal tone and sensation during intercourse.

Vaginoplasty is a surgical procedure designed to tighten the vaginal tissues and to reinforce tone. The external appearance of the vagina is restored.

Hypertrophic labia minora

The labia minora helps cushion the inner vagina and clitoris from friction, impact, and damage. Most women who are born with longer or asymmetrical labia minora have no problems and there is no cause of concern as this is part of the normal variation in appearance. For some women, however, this can cause discomfort during intercourse, frequent irritation and even ulcers during certain activities (cycling, horse riding). Others simply do not like the appearance.

Treatment

Labiaplasty addresses these concerns by removing excess skin and reshaping the labia minora to be more naturally symmetrical.

Top