Less invasive procedure means quicker recovery, fewer complications
Many women suffer from urinary incontinence in silence and refuse to acknowledge to anyone, even their doctors, that they have a problem. But a new procedure offers hope for the millions of women who have "stress" incontinence, brought on by coughing, laughing or other activities of daily life.
"Despite the fact that they can receive significant relief from this debilitating condition, many women have opted to curb their activities and live with urinary incontinence because of embarrassment," says Harry Johnson, M.D., a urogynecologist at the University of Maryland Medical Center and associate professor of obstetrics, gynecology and reproductive sciences at the University of Maryland School of Medicine.
Johnson is one of only a few physicians in Maryland who are trained in a new minimally-invasive procedure called TVT, which stands for tension-free vaginal tape, that is performed under local anesthesia in about 30 minutes. The tape, made of a mesh material, is inserted beneath the urethra to support it during sudden movements. This allows the urethra to remain closed and prevents the loss of urine.
According to national studies, the TVT procedure has successfully treated 86 percent of 15,000 patients treated worldwide.
An estimated 10 to 25 percent of women under age 65 and up to half of women over age 60 suffer from stress urinary incontinence, an involuntary release of urine at least once a week due to a weakening of urethral support. Treatment options typically focus on Kegel muscle-strengthening exercises, medication and/or surgery but fewer than half of those with urinary incontinence seek help.
"This new procedure may be an option for many women who are restricted in their daily activities or suffer depression from urinary incontinence," says Dr. Johnson, who is training other doctors to perform TVT, which was approved by the FDA last year
Stress incontinence affects women of all ages and most frequently is brought on by childbirth, pelvic surgery, menopause or estrogen deficiency and/or neurological conditions, such as spinal cord defects.
The result is that women, when they perform basic activities such as laughing, sneezing and coughing (especially now in the midst of allergy season), lose control of their pelvic muscles and urinate. This could also happen when they're walking, exercising or getting up from a seated or lying position.
"You can see how this condition could dramatically curtail a woman's normal activities and decrease her comfort level with leaving home, socializing and being part of community functions," says Dr. Johnson Women who undergo the TVT procedure can expect a 2-3 week recovery period.
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