Bladder Disorders

The Different Types of Bladder Control Problems and Possible Solutions

Urinary Bladder Control problems affect the lives of over 13 million women in the United States. Urinary Bladder Control problems are the body’s inability to control muscles that control the release of urine. Bladder Control Problems have the potential to impact one’s quality of life, however, with the appropriate treatment, the condition is treatable.

What are the different types of Urinary Bladder Control Problems?

  • Stress Urinary bladder control problems: leakage of urine during physical activity such as coughing, sneezing, laughing and exercise.
  • Urge bladder control problems: experiencing a strong, intense urge to urinate, followed by leakage of urine, possibly occurring even after urination.
  • Mixed bladder control problems: having symptoms of both stress and urge bladder control problems.
  • Overflow bladder control problems: leakage occurs because the bladder never completely empties.

Why do I have SUI (Stress Urinary Incontinence)?

SUI affects women of all ages. SUI is not a condition, however, that is bound to occur in a woman. Possible causes of the condition include:
  • Strenuous activity or exercise: vigorous exercise and/or physical straining can put additional stress on the pelvic area, resulting in SUI if the pelvic and urethral muscles are already somewhat weakened.
  • Pregnancy and natural childbirth: pregnancy and natural childbirth put some degree of stress on a woman’s pelvic muscles and ligaments, and the impact of this stress may become more evident with aging.
  • Menopause Hormone Changes: as a woman’s hormone balance changes through the different stages of menopause. This can lead to weakening of the muscles that control urine leakage.
  • Prior gynecologic surgeries: certain types of gynecologic surgery may have an effect on the overall strength of pelvic and urethral muscles, leading to a woman having difficulty holding urine when pelvic muscles are strained or stressed.

What treatment options are available?

  • Muscle Retraining/Behavioral Therapy: a series of exercises is sometimes used to help strengthen and learn to control the muscles involved in urination.
  • Medication: in most cases, SUI is not effectively treated with medication. This option is usually reserved for other types of bladder control problems.
  • Bulking agents: this involves the injection of a “bulking agent” (such as collagen) into urethral tissues to maintain closure of the urethra and thereby preventing accidental leakage. This can be effective for those who are not good candidates for surgery.
  • Surgery: this is performed to help restore the body’s natural functioning of the urinary tract. Most surgical procedures today are minimally invasive and effective, with few complications.

Mid-Urethral Sling (MUS) FAQ's

Frequently Asked Questions by patients with Mid-Urethral sling for Stress Urinary Incontinence.

A mid-urethral sling is a small mesh strip used in surgery to treat stress urinary incontinence, a type of urine leakage that occurs during activities such as laughing, coughing, or exercise. The mid-urethral sling works to prevent or significantly reduce the loss of urine during these activities.
Mid-urethral sling surgery is performed to correct urinary incontinence. It is a minimally invasive procedure that can be done on an outpatient basis. The surgery is performed through a small incision in the vagina below the urethra (the tube through which urine passes from the bladder). Through this incision, a half-inch wide strip of polypropylene mesh is placed between the urethra and the vagina. The ends of the sling are passed out of small incisions in the groin or above the pubic bone, allowing a hammock of mesh support under the urethra. Using suture that eventually will dissolve, the vaginal incision is closed. The incisions are closed with either surgical glue or dissolvable suture. Mid-urethral sling surgery has a high success rate and can provide significant symptom relief for women. Complications from the surgery are rare but can include infection, pain, and urinary retention.
A midurethral sling is a wedge of surgical mesh that is inserted through a vaginal incision to correct stress urinary incontinence (SUI). SUI is the involuntary leakage of urine during activities such as coughing, laughing, or exercise. A midurethral sling supports the urethra in its new position and prevents urine from leaking. The midurethral sling is made out of the same material as a vaginal prolapse mesh, but it is smaller and placed in a different location. A vaginal prolapse mesh is used to correct a vaginal bulge or pelvic organ prolapse (eg, prolapse of the front wall of the vagina or “cystocele,” prolapse of the back wall of the vagina or “rectocele,” or prolapse of the top of the vagina which may include the uterus). The midurethral sling and vaginal prolapse mesh are both made out of polypropylene, a type of plastic that is absorbable by the body. The midurethral sling will dissolve over time, while the vaginal prolapse mesh will remain in place indefinitely. Both procedures are performed through a small incision in the vagina and do not require an external incision.
The mid-urethral sling is considered a safe and effective treatment for incontinence, according to the U.S. Food and Drug Administration (FDA). Complications can occur but they are typically minor and can usually be repaired. The most common complication is mesh exposure through the lining of the vagina. However, as with any surgery, more serious complications can occur, such as the mesh pushing into the urethra or bladder. Despite these risks, our societies believe that for most patients the benefits of the mid-urethral sling outweigh the risks.
No. The current knitted polypropylene mid-urethral sling has not been recalled by the FDA. The full-length knitted polypropylene mid-urethral sling has been reviewed by the FDA and found to be safe and effective. The mesh products intended to repair pelvic organ prolapse are different from those used to repair stress urinary incontinence. The FDA has not recalled any products intended for use in either of these surgeries, and both procedures have been found to be safe and effective when performed by trained surgeons. Anyone considering either surgery should consult with a qualified medical professional to discuss the risks and benefits.
Single-incision slings are placed through a vaginal incision without incisions in the groin or pubic area. The strip of mesh used in this sling is shorter than in a full-length sling, so they are also referred to as mini slings. Studies comparing single-incision slings to other full-length mid-urethral slings show similar efficacy, though these studies have shorter length of follow-up outcomes and fewer patients than the studies of full-length mid-urethral slings.

Mid-urethral sling surgery is a minimally invasive surgical procedure used to treat stress urinary incontinence (SUI) in women. It involves placing a small strip of mesh under the urethra to provide support and prevent leakage. Single-incision slings offer several potential advantages over traditional mid-urethral sling surgery, including smaller incisions, less scarring, and quicker recovery times. However, it is important to note that these benefits have not been definitively proven in large clinical trials. If you are considering treatment for SUI, talk to your doctor about all of your options to make sure you choose the best treatment for you.
The mid-urethral sling is the most studied surgery to treat stress urinary incontinence, with more than 2,000 articles published on the topic in prestigious medical journals. Two large government-funded studies have evaluated the mid-urethral sling's safety and effectiveness, and both found the procedure to have a low complication rate and a high success rate. The mid-urethral sling is a minimally invasive surgical procedure that can be performed on an outpatient basis. It involves placing a small band of material under the urethra to lift and support it. This helps to close off the urethra so that urine cannot leak out during activities such as coughing, sneezing, or exercise. The mid-urethral sling is an effective treatment for stress urinary incontinence, with a success rate of about 80-90%. It is a safe and minimally invasive surgical procedure with a low complication rate. If you are suffering from stress urinary incontinence, the mid-urethral sling may be an option for you. Talk to your doctor about whether this procedure is right for you.
The mid-urethral sling was first performed in Europe in the early 1990s as a minimally-invasive surgery to treat incontinence in women. The FDA approved the first mid-urethral sling for use in the United States in 1998, and since that time, more than 3.6 million mid-urethral sling procedures have been performed worldwide. Scientific articles report a high satisfaction rate with few serious long-term complications related to the mid-urethral sling (10-17 years after the sling was placed). These findings indicate that the mid-urethral sling is a safe and effective treatment option for incontinence in women.
The mid-urethral sling is a surgical procedure that has been found to be more effective in the treatment of stress urinary incontinence than pelvic floor physical therapy. Other procedures for the treatment of stress urinary incontinence include the injection of a bulking substance into the urethra to treat stress urinary incontinence. Although not as effective nor as durable as the surgical stress urinary incontinence treatments, urethral bulking injections are important non-mesh alternatives and can sometimes be done in the office. Historically, more than 130 procedures for stress urinary incontinence have been described. Examples of these procedures include: pubovaginal sling, transvaginal needle suspension, periurethral injectable bulking agents, and urethral diversion. The goal of these surgeries is to provide support to the urethra so that it does not collapse when pressure is applied, such as during coughing or sneezing. Each type of surgery has its own advantages and disadvantages and should be discussed with a qualified healthcare provider prior to making a decision.

There are many non-surgical and surgical options available for the treatment of stress urinary incontinence. It is important to discuss all of your options with a qualified healthcare provider prior to making a decision.
Transvaginal mesh is a type of surgery used to help treat pelvic organ prolapse and incontinence in women. The mesh is usually made of synthetic materials and is placed through the vagina to support the organs. It can also be used to create a mid-urethral sling, which supports the urethra and helps prevent incontinence. The FDA has issued several warnings regarding complications associated with transvaginal mesh, including pelvic pain, pain during sex, infection, urinary problems, and recurrence of prolapse or incontinence. In some cases, the mesh may erode through the vagina or cause other serious complications. As a result, the FDA has ordered transvaginal mesh for prolapse repair off the market. Women who have had this type of surgery should talk to their doctor about any concerns or possible complications.

The mid-urethral sling is a type of surgery used to treat incontinence in women. The surgery involves placing a small piece of mesh under the urethra to help support it and prevent leakage. The procedure is performed through small incisions in the vagina and abdomen, and is considered to be safe and effective. In 2019, the FDA reaffirmed its findings from a safety panel and literature review stating that the mid-urethral sling is safe and effective. The FDA has not recalled or published warnings against the use of the mid-urethral sling, and most experts who deal with female stress urinary incontinence are supportive of its use. The majority of women who have had the mid-urethral sling surgery are satisfied with the results.
There is no evidence that the mid-urethral sling causes cancer. Two published studies with over 10,000 patients found no increase in cancer in patients who underwent mid-urethral sling surgery compared to the general population. The mid-urethral sling is a safe and effective treatment option for female stress urinary incontinence.
There is no evidence that polypropylene mesh or mid-urethral sling cause other diseases.

Void Diary

The voiding diary is an important tool to help you and your physician better identify your condition and choose the best treatment for you.
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