PreOp Mesh Sling for Stress Urinary Incontinence Female

PreOp® Mesh Sling Procedure for Stress Urinary Incontinence (Female)  https://mkt.preop.com/course/mesh-sling-procedure-for-stress-urinary-incontinence-female/



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Your doctor has recommended a mesh sling to treat your stress urinary incontinence.  Before we talk about this surgical option, let’s review some information about the female body and this medical condition.



The female bladder is behind the pubic bone and on top of the vagina.   It is in the pelvis, the lowest part of the body between the hips. 



The bladder muscle squeezes to empty urine through a short tube called the urethra. This tube lies under the pubic bone and in front of the vagina.



The urethral sphincter is a muscle at the opening to the bladder.  You control urination by relaxing and squeezing this muscle.

Stress urinary incontinence , SUI is uncontrolled urine leaking from pressure on the bladder and urethra.  This pressure  happens with sneezing, coughing, laughing and exercise.   



SUI is a problem when the pelvic muscles that support the bladder and urethra, or the urethral sphincter are weak.

Support problems can start from pressure on these muscles with pregnancy and childbirth, chronic constipation, extra body weight, smoking, coughing and certain activities like heavy lifting that are repeated often. 



Other risks for female SUI include



low estrogen and menopause



genetics, meaning a woman can be born at risk for weak tissue



and it can be an occasional side effect of pelvic surgery



Some changes can make  leaking better without surgery, drink smaller amounts at a time, quit smoking if you smoke and work to get to a healthy weight if you are overweight.



Another way to help stop leaking without surgery is to make pelvic muscles stronger with Kegels, also called pelvic floor exercise.  These exercises can help before and after incontinence surgery. 



Physical therapists can help with these exercises.  They will sometimes use biofeedback therapy to test if you are exercising the right muscles.  Other tools for this therapy are electrical stimulation and vaginal weights.



If exercise and other changes have not helped stop the leaking then bulking agents may be an option.  Silicone microbeads or another material is injected into the urethra to make the wall thicker so that it closes more tightly.  Many patients are better after this but the leaking eventually returns for most. The injection may be repeated.



Bulking agents are most helpful for people with mild SUI, for patients not ready for surgery and patients that cannot or should not have surgery.



The sling procedure is a permanent surgical treatment option for women with problem leaking from SUI.



A sling is a ribbon which can be made of human tissue or plastic fabric called mesh. The ribbon is looped under the urethra during surgery, to create a sling or hammock.  This adds support for the weak tissues and urethral sphincter and helps stop leaking for most patients.



Your surgeon has recommended a mesh sling for you.  This means that your sling will be made of a ribbon of plastic fabric called polypropylene. 



The main benefits to using mesh instead of human tissue are



mesh slings are faster and easier to place



less time is spent in surgery



incisions are smaller



so healing is faster than if the sling was made from your own tissue.



Mesh slings have been used to treat SUI for over 15 years.  About 8 out of 10 women have no leaking or are drier after this procedure.   As with any surgery there can be problems or complications for some patients.



Mesh exposure in the vagina is one problem that can affect about  3 percent or 3 in 100 women after a mesh sling.  This is when a piece of the mesh is not completely covered by the vaginal wall after healing.



A small edge of the mesh can be felt by the patient or their partner as a screen or gritty patch in the vagina. This can usually be fixed with a minor procedure to trim and cover the mesh. If the exposed mesh is not causing the patient any problems, it can be safe to leave untreated, and repair if new problems develop.

Mesh exposure is more common in patients that have thin delicate vaginal tissue from low estrogen. You may be advised to use estrogen vaginal cream before or after surgery.

Rarely, the mesh causes painful scar tissue, erosion or damage to the bladder or urethra. Some problems, especially pain are not able to be fixed with surgery.



There are three main types of mesh sling procedure: mini sling, retropubic and transobturator .  Each way of placing the mesh has its own risks and benefits.



Mini Slings are the newest procedure. They use the smallest size mesh and only need one small vaginal incision to place.  But we are still learning about how well these work and the problems that patients may have.



#bladdercancer #urology #cystoscopy

Cystoscopy Procedure Male - PreOp® Patient Education and Patient Engagement

Cystoscopy Procedure Male  - PreOp® Patient Education and Patient Engagement - https://store.preop.com/shop/mens-center/cystoscopy-male/



Your doctor has recommended that you undergo a Cystoscopy. But what does that actually mean?



The lower urinary tract allows your body to store and release urine.

It's made up of two parts, the bladder and the urethra.



Your bladder is a hollow organ that expands as it fills with urine. Because it is made of muscular tissue, it can also contract and force urine to pass out of the body, through the urethra. Your urethra carries urine from the bladder all the way through the opening in the penis.



Your doctor feels that it is necessary to examine the interior of the urethra and bladder, to try to determine the cause of a problem that you may be having.



Symptoms that may call for a routine Cystoscopy include:



    * Persistent infection of the urinary tract

    * Bladder stones

    * Bleeding while urinating

    * Irritation due to polyps, or

    * Changes to the bladder caused by cancer.



Cystoscopy is a simple procedure during which your doctor will insert a well-lubricated, instrument called a cystoscope through your urethra and into your bladder.



The cystoscope allows your doctor to visually inspect the interior of your bladder. It also allows your doctor to remove small pieces of tissue for later examination and even to crush small bladder stones, should any be present.



Any tissue that your doctor removes from your bladder will be sent immediately to a laboratory for analysis. Your doctor will ask the laboratory to check for any sign of cancer or other abnormality.



So make sure that you ask your doctor to carefully explain the reasons behind this recommendation.



Your Procedure:



On the day of your operation, you will be asked to put on a surgical gown.



You may receive a sedative by mouth and an intravenous line may be put in.



You will then be transferred to the operating table.



Once on the table, your feet and legs will be placed in an elevated position with your knees apart.



You'll be asked to urinate so the amount of urine remaining in the bladder can be measured.



The nurse will swab the penis with an antiseptic solution.



Your doctor will then lift your penis upward.



A well-lubricated cystoscope is gently inserted into the urethra, the opening at the head of the penis, and slowly guided inward.



When the cystoscope reaches the back of the penis, your doctor will pull the penis downward in order to create a straight path into the bladder.



Once the cystoscope is inside the bladder, your doctor will inject a small amount of water through the cystoscope and into the bladder.



The water serves to expand the bladder, helping your doctor to better examine the interior. It also helps by washing away any blood or remaining urine.



You may feel a sense of fullness as though you need to urinate. You'll be encouraged to relax and not to try to retain the water in your bladder.



As the team completes it's inspection, they'll be looking for suspicious tissues. If they find bladder stones, your doctor may try to crush these so that they can pass out of the bladder during normal urination.



If the team finds a suspicious growth they will use a special grasping tool to take a sample of tissue in order to send to a laboratory for analysis.



When the inspection is complete, your doctor will remove the cystoscope and you'll be asked to empty your bladder.



Your doctor will probably ask you to wear a temporary Foley catheter.



A Foley catheter is a narrow tube inserted through your urethra and into your bladder. The catheter is connected to a bag that is attached to your leg by a strap. While the Foley catheter is in place, urine will pass from your bladder into the bag. You will not need to urinate into a toilet.



The nurse will show you how to change the bag when it is full. An appointment will be made for you to return to the doctor's office in a couple of days to have the catheter removed.



As soon as the anesthesia wears off and you feel comfortable, you'll be allowed to leave.



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 PreOp® Cystoscopy Procedure. Male  - PreOp® Patient Education and Patient Engagement

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Your doctor feels that it is necessary to examine the interior of the urethra and bladder, to try to determine the cause of a problem that you may be having.



#bladdercancer #urology #Cystoscopy