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What Causes Stress Incontinence?

Posted on Thu, 3 Apr 2014

Question: Hello, I had the mesh sling to help with stress incontinence. 6 wks post op I'm experiencing urge incontinence. MD said, " give more time". No US on bladder and I suffered for 2 yrs. Read that mesh slings could cause urge incontinence, so I saw another Urologist. Turns out my bladder wasn't emptying after US. So I started the Tamsulin to relax bladder at night. Helped about 40 % Now I'm to try Oxytrol to retain fluid. My issue is having to be on drugs for rest of my light. I want a holistic approach and don't want drugs and side affects causing other issues. Constipation and dry mouth. Then poor dental on top of that. I already have issues with poor gums. I take synthroid and wellbutrin and that's the extent, as I have no choice. {Thyroidectomy and Depression} The other option was snip the sling to take tension off my bladder. I'm concerned that it won"t make any difference. But I don"t want the drugs. MD says give it a try... Besides wearing a diaper at age 51 do you have any thoughts. If it's snipped it may come apart which is another nightmare and probably no intercourse. What are your thoughts. What an awful mistake. As an athlete, {runner biker and skier} I just dehydrate myself to continue with quality of life.... XXXXXXX Burbank Need Consult with UROLOGIST

Answered by Dr. Deepak Kishore Kaltari (2 hours later)

Brief Answer: snipping of sling may be a option Detailed Answer: Hi Welcome to Healthcare-Magic Greetings of the day Stress incontinence in woman is more likely to be related to wide opened bladder neck ( junction of bladder and urethra which normally acts like a valve). The weakness of this valve which usually occurs due to weakness in muscle of pelvic floor and bladder neck is the cause of stress incontinence. The widely used surgery for correction of it is sling operation using mesh. This mesh induces fibrosis and due to its physical presence and fibrosis it strengthen the bladder neck. Too tight sling may cause irritative symptoms in the form of increased frequency of urination. It's usually managed by drugs. One of the other option is partial release of the sling which will decrease the obstructive symptoms. It has helped in couple of my patients. As the strength has already been provided it will not lead to reappearance of symptoms. Do discuss it with your Urologist. Do get back to me if you need any further assistance, will be glad to assist you. Take care Best Regards Dr Deepak Kishore MBBS, MS, MCH Consultant Surgeon

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar