The Everywoman Clinic ( Dr. RISHMA DHILLON PAI)

How can I be sure this is SUI?

A simple gyneclogical examination on a full bladder , by your doctor , can clinch the diagnosis. There are specific tests, such as urodynamic study which can differentiate SUI from irritable bladder or failure of the valve mechanism of the urethra.


Do I need to undergo treatment for this?

SUI is not going to improve on its own, it will probably worsen, especially after menopause. There are conservative treatments such as physiotherapy, pelvic floor exercises (Kegels exercise), electric stimulation etc which may lead to some improvement in symptoms. However these are for mild cases only and results may not be guaranteed.

What are the surgical options for me?

There are many different types of surgeries available and the choice can be made after seeing the nature of the problem and the doctors preference. SUI may be accompanied by sagging of the bladder wall or cystocoele. Both these can be tackled by vaginal cystocoele repair along with the traditional kellys stitch, which is a vaginal approach.




Are there any newer methods of treatment available?

Nowadays the preferred surgeries are open or laparoscopic Burch colposuspension operation, sling operations or needle procedures. The latest techniques are those of TVT (tension free vaginal tape) where a tape is inserted from the vagina and fixed below the middle of the urethra. This is done under local or spinal anaesthesia.
The newest modification is to pass the tape under the bladder opening and bring it out through the obturator foramen situated on the medial side of the thigh ,a shorter and simpler procedure. Most of those procedures give good results and recurrence rates are low.


How risky are these surgeries?

All surgeries come with a certain amount of risk . But most of the surgeries are quick and require no prolonged hospitalization.

Dos & Donts

Make sure your deliveries are conducted under supervision.
Pelvic floor exercises are to be done lifelong.
You dont have to live with the embarassment of SUI.
Alternate forms of treatment can be tried.
Simple & short surgical options are available.

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