UROGYNAECOLOGY
There is no reason to suffer in silence from a pelvic or bladder condition. Nearly 85 to 90 percent of urogynecologic conditions can be diagnosed and successfully treated through minor lifestyle changes, medications, or surgery.
We manage clinical problems associated with dysfunction of the pelvic floor and bladder. Pelvic floor disorders affect the bladder, reproductive organs, and bowels.
Common pelvic floor disorders include urinary incontinence, pelvic organ prolapse, faecal incontinence and problems of trauma to the perineum during childbirth.
Urinary stress incontinence
Urinary stress incontinence occurs when a woman leaks urine when they exercise, cough, sneeze or laugh. It usually happens because the muscles and tissues that make up the pelvic floor have become weak or damaged. The pelvic floor works like a sling that goes from the pubic bone in the front, to the base of the spine at the back. It supports the urethra which is the tube which carries urine down from the bladder. When the pelvic floor is strong and can keep the urethra in the right position, the urethra can form a tight seal so that urine does not leak out. If the pelvic floor is damaged or weak, it does not support the urethra properly. So when a person moves and there is pressure on the urethra, it moves out of position. The tight seal is lost and urine leaks out.
Transobturator tape (TOT) procedure
This is the procedure for urinary stress incontinence and it is performed under a general or spinal anaesthetic.
A small incision is made on the wall of the vagina and the permanent tape is introduced via the vagina to sit under the urethra. The needles used to place the tape are introduced through small incisions at both sides of your upper inner thigh (see picture). The tape used is a permanent mesh, which will not be dissolved in your body.
Trans Vaginal Tape Repair
TVT (trans-vaginal tape) is a minimally invasive surgical procedure for treatment of female stress incontinence that combines the use of a mesh tape, with a traditional incontinence procedure called the sling to support the urethra. The mesh tape loosely supports the middle of the urethra and provides support only when needed, without the tension associated with traditional sling procedure. It creates a “new” hammock for the urethra.
The surgery takes only 30 to 45 minutes. The tape is surgically inserted through a small incision in the vagina and then it is woven through pelvic tissue and positioned underneath the urethra. The tape is then pulled up through two tiny incisions in the skin’s surface just above the pubic area. As it passes through several pelvic tissue layers, friction is created which initially holds the tape in place (like Velcro).