FEMALE URINARY INCONTINENCE TREATMENT SLING TVT TOT DELHI NCR GURGAON
Dr Vijayant Govinda Gupta, is a Urogynecologist in New Delhi and NCR with specialisation in Female Urology. As a part of female urology, treating urinary incontinence in women is leading concern for any urologist. Take an appointment today for lasting freedom from smell and discomfort of leaking urine in women.
WHY IS URINARY INCONTINENCE IN WOMEN A PROBLEM?
Urinary incontinence is a troubling problem for women. Its disastrous because it ruins their social life. Women smell all the time, the inability to reach the loo on time, bed wetting, and dependence on care givers builds a sense of shame and sadness in women and can ruin their emotional and physical self confidence. It can also seriously affect their sexual life and desire creating conflict with their partners.
But, all urinary incontinence in women does not require surgery. Many if not all women with urinary incontinence or leaking urine can benefit from measures in lifestyle that do not require surgery.
WHAT ARE THE TYPES OF URINARY INCONTINENCE IN WOMEN?
Urinary incontinence in women can take many forms –
- It may be the slight leakage that happens when you cough or when you stand up from sitting or bend to do some work. It may be enough to wet your undergarments or may be as slight as to stain it.
- It may be only at night when the women gets up suddenly at night to find her bed wet.
- In some women it may be the inability to reach the bathroom and pass a few drops or wet herself before reaching the toilet.
- And worse for some unfortunate women it may mean continuous dribbling all the time that they forget the last time they were dry.
These urinary incontinence or urinary leak is classified as follows
- The first scenario is Stress urinary incontinence
- The second is what we call nocturnal enuresis
- The third is Urgency or urge Incontinence
- And the fourth is complete urinary incontinence
Each is a separate type requires specialised management to identify the type and choose the appropriate treatment.
WHAT ARE THE DIFFERENT TREATMENT OPTIONS FOR FEMALE URINARY LEAKAGE?
- Lifestyle management It is the bedrock of any therapy aimed at long term results for women suffering from urinary incontinence. A simple step to avoid water at night or good bowel movement may make an old lady dry enough to spend time with her grandchildren and avoid surgery.
- Pelvic Floor muscle training or Kegels Exercises – The corner stone of stress urinary incontinence treatment. Available in manual and automated learning methods, these exercises tighten the weak sphincters of women and may help many young women who suffer temporarily after child birth.
- Medications – Many new and old medications like estrogen and newer drugs like duloxetine are available to manage incontinence.
- Surgery – Continuous incontinence is usually due to urinary fistulas in women. And needs specialised surgery. Read my article here.
ROLE OF MIDURETHRAL SLINGS AND TAPES LIKE TVT AND TOT?
Vaginal tapes or midurethral slings are the in thing today and the toast of the town. From early research in the late 1990’s came this easy solution to stress urinary incontinence. But is it easy and simple. Because of the ease of insertion and expense, slings are being used inappropriately and in an irrational method for treating women with leakage. Result is that today slings are the number one source of litigation in the USA and the world.
Slings and tapes such as transobturator tapes, trans vaginal tapes, monarch etc are a wonderful solution to female urianry leakage. But every leakage does not require a sling and slings do not work on each and every leakage. Appropriate counselling, assessment and trial of conservative therapy is required before proceeding with sling and tape placement.
And sling and tapes irrationally and badly placed can lead to severe complications and even to renal failure. So get appropriate consultation before proceeding. There are alternatives to this surgery like Burch colposuspension, retrovesical slings and pubourethral slings that because of their complexity are being infrequently used but are excellent treatment options.
WHO DOES MIDURETHRAL SLING SURGERY FOR FEMALE URINARY LEAKAGE IN DELHI NCR AND GURGAON?
This surgery is in the middle of two specialities – urology and gynaecology. Urogynaecology is the meeting point of these branches. Very few gynecologists are trained in managing urinary incontinence. Urologist by their training in urodynamics, neurourology and intimate anatomy of the bladder urethra and pelvic floor anatomy are the ideal specialists to treat urinary incontinence in women.
I have trained at PGI Chandigarh and Maulana Azad Medical College, New Delhi where I have exposure and experience in
- Robotic Burch Colposuspension
- TVT O and TOT mid urethral slings
- VVF and Urinary Fistula repair
- Medical management of female incontinence
I can provide you the best treatment for your problem with care, expertise that is scientific ethical and economical.
I still urge you to take second opinions and advice before consultation and set your expectation right because this complex problem requires specialised evaluation and nuanced treatment that cannot provide a magic bullet as a cure.