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Of urethral SUSPENSION SURGERY
TOT [Transobturator cassette], TVT [Tension Free Vaginal Tape], Strap Surgery, Abdominal suspension of the bladder, retropubic suspension, Burch Surgery, MMK [Marshall-Marchetti-Krantz] Surgery
Description
Urethral suspension surgery, women are the surgical procedures used for the treatment of stress inkontinansın. Stress incontinence, the most common type of urinary incontinence involuntary. Here the word stress implied bladder and urethra (the urine from the bladder to the vagina carries urine input channel) is on the increase in intraabdominal pressure. In this way, that leads to the escape of urine caused by increased intraabdominal pressure and coughing, laughing, exercise, or heavy lifting may be hapşurma.
Purpose of the surgical operation
The purpose of the bladder neck suspension surgery, and the urethra is to take normal anotomik position. Returned to their normal position when supported on the bladder and urethra will increase, uncontrolled urinary incontinence will be prevented. Bladder neck, bladder muscle fibers combine üretraya is a structure formed. Majority of women with stress incontinence pelvic muscles and relaxation that is a weakening. This attenuation pregnancy, childbirth, menopause, may have already been passed because of pelvic surgery.
Art During the process of Probability Risk Factors for Complications
During surgery the patient's general health status in determining the likelihood of complications will be. Also the potential complications of pelvic surgery previously been passed increases. Ask your surgeon, complications are likely to be encountered.
Situations in the Process to be surgery Comparison
Before surgery, your doctor will try to find the cause of your incontinence. Your doctor is likely to do the following:
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Medical Stories: Any of whether your disease, you are constantly using drugs, you've had several pregnancies or birth, you've already spent on issues such as surgery, etc. You will be asked questions. How to determine your type of incontinence, in which case you have incontinence, it affects your quality of life and will not affect the question.
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Analysis of urine: a possible infection or other problems that may be required for the diagnosis of urine tests.
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Physical Examination: Physical examination will be done during the detailed vaginal and rectal examination.
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For the evaluation of bladder function and urinary flow may also be interested in additional tests. Urodynamic tests, called these tests are usually temporary catheter must be inserted. Usually, a urologist do these tests for assessing the internal structure of the bladder is called cystoscopy will be performing.
Days before surgery;
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To discuss your surgery will be a anesteziyologla opinions.
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Return home after surgery for a transport plan, please do.
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Unless told otherwise by your doctor after night 12 to do anything inside yeyip
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To wear comfortable clothes you get at the hospital.
Anesthesia
Be done depending on the type of surgery anesthesia, general or regional (spinal, epidural) may be.
Defining transaction:
There are several different types of suspension surgery.
Surgery Transobturator Tape (TOT)
Equivalent to the next level with the clitoris genitals inside of the legs instead of the combination of two facing small incision is made. Make an incision in the vaginal mucosa of the vagina is removed. Band-shaped structure (mesh) in the hammock under the urethra to form a similar support will be placed here. Providing stability and normal urethra pozistonunu this hammock, leading to the opening of any control ensures hapşurma or coughing when the urethra. Into the scar tissue to hold on to the surrounding tissues to develop until the mesh, mesh to keep the place is no need to put any stitching.
Tension Free Vaginal Tape (TVT) Surgery
TOT operation, obturatuar not using the channel path, the pubic bone in the shape of an operation is applied on the region. Band-shaped mesh, the vaginal route, the hammock under the urethra to form a similar support will be placed. TOT operation process and results are expected with similar treatment.
Sling (Hanger) Surgery
This operation is an incision through the vagina is performed. Vaginal tape surgery as in a hammock under the urethra or the suspension will be placed. This led to open hammock or suspend any hapşurma urethra, coughing or other stress factors that closes the urethra. Strap, a synthetic material or vüducun fascia (the muscles surrounding a very strong tissue) can be used.
Retropubic suspension Surgery
A lower abdominal incision is made. The bladder neck and urethra surgeon by placing sutures around the bladder neck close to the suture connective tissue in the pelvis strong ties to the base or the pubic bone. Sewing is connected by location, Burch surgery surgery, surgery, etc. MMK. takes names. This hammock-like seams under the bladder creating a structure supports the urethra. Laparoscopic surgery can be done in this way.
After operation
After surgery recovery room until fully awaken from within the vital signs (pulse, respiration, blood pressure, body temperature) will be monitored. To ensure free urine flow probably would be inserted probe. In the beginning, your urine may look a little bloody, but this will improve over time. Probe according to the type of surgery have made the operation within the next few days, your bladder fully when you regain the ability to discharge will be removed. Made the same day or next day depending on the operation stood up and you can walk. To ensure adequate recovery after surgery, remove pain for 3 months and to avoid over-strenuous activities will be offered.
How Much Time is the surgery?
Will cover a period of generally 1-1.5 hours of surgery.
Will you pain?
Depending on the anesthesia during surgery will not feel any pain. You may feel pain after surgery, especially in the first hour, to resolve this condition will be given strong pain killers.
Possible Complications:
This type of surgery, serious complications are very rare. Any surgical procedure, as there is a small risk of infection and bleeding and anesthetic drugs used against the extreme reaction to anesthesia related complications such as respiratory problems and can be seen.
Some complications are unique to this type of surgery:
Urinary retention (inability to make urine), or insufficient to empty the bladder: The bladder neck, pulled up by the former position as a result of the bladder to adapt to new situations until the problem may be in the patient's urine. Again for the evacuation of the bladder catheter is inserted, the probe and patient urine as they become klemplenir said clamp is open. Urinary retention is often temporary and resolve within a few days, but can rarely find a few months to fix.
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Urge incontinence: a sudden feeling of urination go to the bathroom until the situation on the road, and this type of urinary incontinence after surgery can be seen.
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Especially in older women is tracked vaginal atrophy, vaginal sling surgery, depending on the prosthetic tape and mesh erosion of the wall may be the risk of disclosure.
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To create a hammock in some surgical needle from the abdomen through the vagina and the bladder adjacent organs when there is a risk of injury.
The average stay in hospital
Depending on the type of surgery can be discharged the same day, as you can stay in the hospital a few days.
Postoperative Care
After discharge, especially that increase intraabdominal pressure, such as the absence of coercive action, full-added process improvement as provided for 3 months will be advised to avoid over-strenuous exercise.
Conclusion
Surgical suspension of the urethra, in most cases treat stress incontinence or greatly improves.
Any of the following Olursa please call your doctor
After discharge from the hospital improvement status is important to control yourself. Any of the following occurs please call your doctor quickly.
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Incision (cut) over the redness or swelling
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Increased pain
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Bleeding or discharge from the incision site
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Cough, shortness of breath or chest pain
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Excessive nausea, vomiting
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Burning urination, pain, frequent urination, a sudden feeling of urination occurs.
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Fever or chills
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