Women’s Urinary Incontinence: Overcoming Your Fear of Surgery

When it comes to women’s urinary incontinence, embarrassment tops the list of reasons that affected women don’t seek help. Another major reason these women don’t seek help is this: fear of surgery. Affected women are afraid that seeking a medical diagnosis from a physician will automatically lead to surgery. Many people, not just women with urinary incontinence, have a fear of surgery. Luckily, these fears are mostly unjustified.

Women’s Urinary Incontinence: Try Conservative Methods First
Do you suffer from women’s urinary incontinence, and are you afraid that your doctor might suggest that you have surgery? If so, then we have good news for you. Unless your condition is very severe, most physicians will suggest that you try the least invasive and most conservative therapies first. These include pelvic floor retraining, lifestyle changes (such as weight loss, diet changes, and smoking cessation), bladder retraining, taking medication, using a pessary, and acupuncture. They may even suggest you try a combination of these therapies until you find what works to relieve your symptoms.

An interesting note about these conservative therapies is that they are more effective when used early on–that is, as soon as you notice the first signs of pelvic floor weakness. These therapies are effective for relieving symptoms of all three types of women’s urinary incontinence, as well as alleviating symptoms of pelvic organ prolapse and decreased sexual sensation. This information should definitely motivate you to seek medical help as soon as you begin experiencing problems with your pelvic health.

Overcoming Your Fear of Surgery
But what happens if conservative therapies are not effective for relieving your symptoms? In that case, you may need surgery to address the problem. If your condition is severe, such as when one or more of your pelvic organs have significantly shifted out of position (prolapsed), your physician may recommend surgery as the first step towards curing your condition. Or you may find that conservative therapies are effective for many years, but cease to work over time. This can occur because of aging, menopause, and the continued downward pull of gravity on your pelvic organs. In this case, you may also need surgery to alleviate symptoms that were formerly relieved by conservative therapies.

If your physician does recommend surgery, don’t hit the panic button just yet. We have some statistics about women’s pelvic surgeries that should help you breathe a sigh of relief, especially if you have a fear of surgery. We have categorized the different types of surgeries according to the condition treated, and we describe the level of invasiveness for each procedure as well as the success rate. Minimally-invasive surgeries are usually done as outpatient procedures, and you often go home the same day. Surgical procedures with a moderate level of invasiveness may require a short stay in the hospital.

Surgeries for Stress Urinary Incontinence
Number of Procedures: 6
Names: Transobturator tape, single-incision transobturator tape, tension-free vaginal tape, pubovaginal sling, Burch procedure, Marshall-Marchetti-Krantz procedure
Invasiveness: The first three procedures are minimally invasive, the last three are considered moderate.
Success Rates: No procedure has less than a 66% success rates, and most have success rates between 70% and 95%.

Surgeries for Overactive Bladder, Urge Urinary Incontinence, Urge-Dominant Mixed Incontinence, and Urinary Retention
Number of Procedures: 1
Name: Sacral neuro-modulation
Invasiveness: Minimal
Success Rates: 31% to 65%

Surgeries for Pelvic Organ Prolapse
Number of Procedures: 4
Names: Cystocele repair (bladder hernia), rectocele repair (large intestine hernia), enterocele repair (small intestine hernia), sacral colpopexy (vaginal vault prolapse)
Invasiveness: All are considered moderate
Success Rates: 80% to 96%

As you can see, almost all the surgeries have a very high success rate, and the majority are minimally-invasive. This list of women’s pelvic surgeries should give you a starting point for discussing your surgical options with your physician. If you have a significant fear of surgery or simply want to avoid surgery for any reason, you may wish to seek a second opinion from another specialist. Additionally, you may want to ask your physician whether a different type or a different combination of conservative therapies would be useful to try before having surgery. For many women, the first few conservative therapies tried are not completely successful at relieving symptoms. The women who have the most success with conservative therapies are those willing to try multiple approaches or multiple combinations of therapies until they find something that works. Persistence is often the key to success when working with conservative therapies.

If you ultimately decide to undergo surgery for your pelvic health condition, rest assured that success rates are high and most procedures pose a fairly low risk. Be sure to discuss any questions or concerns with your physician until you feel completely comfortable with any proposed surgery. In this case, educating yourself about your condition and your options is the best medicine!

 

If you enjoyed this post, we invite you to leave a comment, contact us, download our free ebook, or interact with us on Twitter and Facebook.