Surgical Treatment of Urinary Incontinence / Bratislava / Piešťany

What is surgical treatment of urinary incontinence actually?

Urinary incontinence is involuntary leakage of urine in women, which causes social or hygienic problems for the patient. Although urinary incontinence is not a life-threatening disease, it can cause long-term stress and worsen the quality of life for the patient.

At our workplace, we are happy to explain which method of urinary incontinence treatment is most optimal for you. Surgical treatment of urinary incontinence with transobturator tape / T.O.T./ or laser treatment? Which one is more suitable for you?

Based on symptoms, we divide incontinence into these types: 

• Urge urinary incontinence – this is involuntary leakage of a larger amount of urine, preceded by a strong urge to urinate.

• Stress urinary incontinence – this is involuntary leakage of urine in women during physical activities such as exercise, dancing, lifting weights or sneezing and coughing. It occurs due to pelvic floor disorders (e.g.: after childbirth, surgery, nerve damage).

• Other types of incontinence – we can include so-called mixed incontinence, which is a combination of urge incontinence and stress incontinence, or overflow incontinence and others.

Incontinence is divided into three degrees based on the intensity of urine leakage

• 1st degree – occasional urine leakage in drops, for example when sneezing, laughing or lifting heavy weights. In the first degree of incontinence, involuntary urine leakage should not occur more than twice a day.

• 2nd degree – frequent urine leakage – urine leaks involuntarily in a stream, several times a day even during lighter physical activities such as running, walking and similar. 

• 3rd degree – permanent urine leakage – urine leaks involuntarily several times a day with minimal exertion even during the night while lying down.

Laser treatment of urinary incontinence

Our workplace is a reference center for laser treatment of urinary incontinence in Slovakia. We perform laser treatment of urinary incontinence in women on an outpatient basis without the need for hospitalization. The treatment is painless and suitable also for patients who for various reasons cannot or do not want to undergo surgical treatment of urinary incontinence.

How does laser treatment of incontinence work?

The procedure takes 15-20 minutes and does not require hospitalization. The essence of the effect is photothermal tightening of the vaginal mucosa and stimulation of collagen formation in the ligament of the urethral suspension apparatus, which ensures restoration of urethral support with regression of incontinence. It is a safe and effective therapy. The advantage of this treatment is also vaginal rejuvenation, improvement of vaginal moisture during sexual intercourse and increase in the level of local immunity in the vagina with a lower number of vaginal infections. The advantages of this method are painlessness, non-invasiveness (without cutting, bleeding and sutures) and outpatient performance without the need for hospitalization.

The highest efficiency is achieved in patients with mild degree of stress urinary incontinence (up to 94%) with the need for 1-2 smaller pads daily. Good effects with improvement are also achieved in patients with mixed incontinence (68%) of urine in combination with pharmacotherapy.

At our workplace, all procedures are performed by our experienced doctors – urologists with long-term diagnostic and surgical experience in the field of incontinence medicine, able to handle not only simple but also complicated conditions and forms of urinary incontinence. In our portfolio we have more than 6000 successfully treated patients with urinary leakage. Unlike some other workplaces, where urinary leakage treatment is performed by doctors who are not urologists and who prefer and provide only laser treatment.

Surgical treatment of urinary incontinence by insertion of transobturator suburethral tape / T.O.T. /

Thanks to the specialization of our doctors, our workplace provides not only laser treatment, but also surgical treatment of stress urinary incontinence in case of more severe degrees. Before each treatment, we perform thorough diagnostics of the patient and propose an individual treatment procedure that respects the patient’s wishes, her age, associated diagnoses, type of urinary incontinence and its degree.

In case of severe forms of stress urinary incontinence (2nd to 3rd degree), surgical solution is usually most suitable. In more severe forms of stress urinary incontinence with more significant pad consumption, laser treatment is usually no longer effective. At our workplace, we try to accommodate all patients with incontinence and propose a really effective solution for them, so that we respect the type and degree of incontinence, take into account their overall health condition and expectations from treatment.

What problems does surgical treatment of urinary incontinence solve?

The procedure solves problems with urinary leakage in women.

What are the advantages of surgical treatment of urinary incontinence?

Application of suburethral tape using transobturator approach represents an effective and fast solution for moderate to severe stress incontinence. The main advantage is immediate effect – most women have the ability to hold urine almost immediately after surgery, which leads to significant improvement in comfort and self-confidence.

The application itself is performed microsurgically with minimal invasiveness – incisions are small and barely visible after healing. The patient can leave the hospital the next day. Weekly sick leave and period of mild restriction of physical activity are significantly shorter than with traditional surgical procedures – most return to normal life after 1-2 weeks, while full activity is possible after 1-3 months.

What are the risks of surgical treatment of urinary incontinence?

As with any surgical procedure, there are potential risks here too. The most common include temporary difficulties with urination, such as delayed urination or urinary retention, which usually resolves within 1-2 weeks. Rarely, temporary catheterization may be necessary. Exceptional, but possible complications include damage to the urinary tract during needle insertion, tape erosion into the vagina or bladder, groin or leg pain, and in exceptional cases, the need for further adjustments or tape removal.

How does the surgical treatment of urinary incontinence work?

The surgical treatment of stress urinary incontinence requires a short hospital stay of up to 24 hours. It is performed under general anesthesia. Before the surgery, the patient undergoes diagnostics to determine the exact type and degree of urinary incontinence, based on which we recommend the optimal treatment approach.

In cases of more severe stress urinary incontinence (leakage during coughing, laughing, running, or other normal physical activity) with significant pad usage and good overall health without major complicating factors, we recommend surgical treatment. After completing preoperative internal and anesthesiological assessments, we proceed with the surgery.

The surgery itself usually takes about 20–30 minutes. Our clinic performs the treatment using the certified ARIS suburethral sling from the renowned manufacturer COLOPLAST. After surgery, two small 1 cm scars appear in the skin fold between the thigh and pubic area, and one small 2 cm scar on the anterior vaginal wall. These scars usually heal well and become barely visible a few months after surgery.

The patient is discharged home within 24 hours. After one week of sick leave, it is usually possible to return to work. We recommend avoiding heavy physical activity for three months and abstaining from sexual intercourse for four weeks. The result of the operation is the disappearance of urine leakage immediately after surgery. During the postoperative period, the patient may feel slight tension in the area of the surgical wounds, which usually disappears within two months.

Here you can watch a video of the surgery for urinary incontinence:

• https://iu.coloplast.us/female-pelvic-medicine/clinical-education/?video=250844490
• https://www.coloplast.us/surgical-urology/professional/female-urinary-incontinence/#section=Aris-Sling-Surgical-Implant-Procedure_100559

Who performs the surgical treatment of urinary incontinence at the Lauros clinic?

The surgery is performed by MUDr. Milan Gajdoš, MPH, who has carried out more than 7,000 urological and sexological procedures. The doctor performs surgeries in Bratislava and Piešťany.

How much does the surgical treatment of urinary incontinence cost?

If you have health insurance, the procedure is covered by your insurance company. An optional extra is the choice of a specific surgeon for an additional fee of 400 EUR.

Who is the surgical treatment of urinary incontinence intended for?

The procedure is intended for women with urinary leakage.

Who is the surgical treatment of urinary incontinence not intended for?

The procedure is not intended for men, women with gynecologic-oncological diseases, women with acute gynecological or urinary tract infections, or pregnant women.

What is the process before the surgical treatment of urinary incontinence?

Before the procedure, an examination at our clinic is required to determine the type and degree of urinary incontinence. We will explain the treatment options that are most suitable for you. If surgical treatment is chosen, it must be preceded by internal and anesthesiological preoperative examinations. The procedure should be scheduled outside the menstrual period.

What happens after the surgical treatment of urinary incontinence?

The patient is discharged home within 24 hours. After one week of sick leave, it is usually possible to return to work. We recommend avoiding heavy physical activity for three months and abstaining from sexual intercourse for four weeks. The result of the operation is the disappearance of urine leakage immediately after surgery. During the postoperative period, the patient may feel slight tension in the area of the surgical wounds, which usually disappears within two months.

What does the completed surgical treatment of urinary incontinence look like?

In this section, we present a gallery of photographs showing what the completed surgical treatment of urinary incontinence looks like. The images are for illustrative purposes only to give you an idea of the outcome.