Much more common in women than in men, bladder suspension surgery is a surgical procedure performed to lift a sagging or prolapsed bladder into its proper position. It is often performed to relieve the symptoms of stress urinary incontinence. The main causes of stress urinary incontinence are childbirth and the hormonal changes due to menopause, which weaken the pelvic floor muscles and lead to the leakage of urine when coughing, sneezing, or with physical activity. This surgery can be very effective in minimizing these symptoms, if diagnosed properly in the first place.
Stress urinary incontinence is reported to affect close to 20 million women, half of whom are over the age of 60. Since the symptoms of this condition are also those of urinary urgency, a proper diagnosis is necessary as bladder suspension surgery only helps those with true stress urinary incontinence. This procedure will not improve the symptoms of those suffering from urinary urgency or urinary frequency.
The surgery itself can be accomplished in one of several ways. An open retropubic suspension procedure entails an abdominal incision and pulling up and securing the bladder neck. This can also be accomplished through laparoscopic surgery, through a small incision in the vaginal wall.
The surgery that has shown the best success rate is known as the sling procedure. Fascia or tissue from the patient is used to form a sling to hold the bladder, urethra, and bladder neck in place. Sometimes a piece of mesh can also be used. Both the open retropubic and the sling procedure require a short hospital stay.
Most cases of severe stress urinary incontinence are successfully corrected with surgery. Bladder suspension surgery is credited with an 85 to 90% success rate, but symptoms can recur in as little as five years, so patients may have to undergo the procedure more than once to control their stress urinary incontinence. Age, obesity, hormone levels, and physical activity all play a part in determining how long the effects of the surgery are effective.
Recovery time after bladder suspension surgery depends on the choice of an open surgical procedure as opposed to one done laparoscopically. As a general rule, recovery will take longer with an open procedure. With either procedure, discomfort can last up to six weeks. Risks and complications include inability to urinate, infection, an overactive bladder, or reactions to anesthesia.
The number one reason cited for the failure of bladder suspension surgery was an incorrect diagnosis. For this reason, a second opinion is a good idea for anyone considering this treatment. A second opinion can help a patient make the decision of whether this surgery is the best choice for the symptoms exhibited.
