Urinary incontinence surgery - female - discharge
Open retropubic colposuspension - discharge; Laparoscopic retropubic colposuspension - discharge; Needle suspension - discharge; Burch colposuspension - discharge; VOS - discharge; Urethral sling - discharge; Pubo-vaginal sling - discharge; Pereyra, Stamey, Raz, and Gittes procedures - discharge; Tension free vaginal tape - discharge; Transobturator sling - discharge; Marshall-Marchetti retropubic bladder suspension - discharge, Marshal-Marcheti-Krantz (MMK) - discharge
Stress incontinence is a leakage of urine that happens when you are active or when there is pressure on your pelvic area. You had surgery to correct this problem. This article tells you how to take care of yourself after you leave the hospital.
When you enter a store or restaurant, are you often looking to find the establishments bathroom? If you're having trouble holding in your urine, or if you often leak urine, you probably have what's called urinary incontinence. Normally, the bladder begins to fill with urine from the kidneys. The bladder stretches to allow more and more urine. You should feel the first urge to urinate when there is about 200 mL, just under 1 cup of urine stored in your bladder. A healthy nervous system will respond to this stretching sensation by letting you know that you have to urinate. But, at the same time, the bladder should keep filling. But the system doesn't work correctly in people with urinary incontinence. Some people with urinary incontinence leak urine during activities like coughing, sneezing, laughing, or exercise. This is called stress incontinence. When you have a sudden, strong need to urinate, but can't make it to the bathroom before you do urinate, it's called urge incontinence. Other people have what's called overflow incontinence, when the bladder cannot empty and they dribble. Urinary incontinence can have many causes, and it's most common in older adults. Women are more likely than men to have it. For some people the bladder muscle is overactive. For others, the muscles holding the urine in are weak. And for others, the problem is sensing when the bladder is full. They might have brain or nerve problems, dementia or other health problems that make it hard to feel and respond to the urge to urinate, or problems with the urinary system itself. To treat urinary incontinence, your doctor can help you form a treatment plan. Most likely, exercises to strengthen the muscles of your pelvic floor will be part of that plan. Bladder training exercises can also be effective. And depending on the cause of incontinence, oral medications, or topical estrogen may be helpful. If you have overflow incontinence and cannot empty your bladder completely, you may need to use a catheter. Your doctor can recommend the best catheter for you. For urine leaks, you might wear absorbent pads or undergarments. Whatever else you try, lifestyle changes may help. Aim for an ideal weight. Losing excess weight and increasing exercise both often improve incontinence, especially in women. Also, some specific beverages and foods might increase leaking in some people. For instance, you might try eliminating alcohol, caffeine, carbonated beverages, even decaf coffee. Drink plenty of water, but do NOT drink anything 2 to 4 hours before going to bed. Be sure to empty your bladder before going to bed to help prevent urine leakage at night. Throughout the day, urinate at set times, even if you do not feel the urge. Schedule yourself every 3 to 4 hours. Urinary incontinence is very common, but many people never talk to their doctor about it. Don't let that be you. See your doctor and bring it up at your next doctor's visit.
When You're in the Hospital
Stress incontinence is a leakage of urine that happens when you are active or when there is pressure on your pelvic area. Walking or doing other exercise, lifting, coughing, sneezing, and laughing can all cause stress incontinence. You had surgery to correct this problem. Your doctor operated on the ligaments and other body tissues that hold your bladder or urethra in place.
What to Expect at Home
You may be tired and need more rest for about 4 weeks. You may have pain or discomfort in your vaginal area or leg for a few months. Light bleeding or discharge from the vagina is normal.
You may go home with a catheter (tube) to drain urine from your bladder.
Take care of your surgical incision (cut).
- You may shower 1 or 2 days after your surgery. Gently wash the incision with mild soap and rinse well. Gently pat dry. Do not take baths or submerge yourself in water until your incision has healed.
- After 7 days, you can take off the tape which may have been used to close your surgical incision.
- Keep a dry dressing over the incision. Change the dressing every day, or more often if there is heavy drainage.
- Make sure you have enough dressing supplies at home.
Nothing should go into the vagina for at least 6 weeks. If you are menstruating, do not use tampons for at least 6 weeks. Use pads instead. Do not douche. Do not have sexual intercourse during this time.
Try to prevent constipation. Straining during bowel movements will put pressure on your incision.
- Eat foods that have a lot of fiber.
- Use stool softeners. You can get these at any pharmacy.
- Drink extra fluids to help keep your stools loose.
- Ask your doctor before you use a laxative or enema. Some types may not be safe for you.
Your health care provider may ask you to wear compression stockings for 4 to 6 weeks. These will improve your circulation and help prevent blood clots from forming.
Know the signs and symptoms of a urinary tract infection. Ask your provider for information about this. Call your provider if you think you might have a urinary tract infection.
You may slowly start your normal household activities. But be careful not to get overtired.
Walk up and down stairs slowly. Walk each day. Start slowly with 5-minute walks 3 or 4 times a day. Slowly increase the length of your walks.
Do not lift anything heavier than 10 pounds (4.5 kg) for at least 4 to 6 weeks. Lifting heavy objects puts too much stress on your incision.
Do not do strenuous activities, such as golfing, playing tennis, bowling, running, biking, weight lifting, gardening or mowing, and vacuuming for 6 to 8 weeks. Ask your provider when it is OK to start.
You may be able to return to work within a few weeks if your work is not strenuous. Ask your provider when it will be OK for you to go back.
You may start sexual activity after 6 weeks. Ask your provider when it will be OK to start.
Going Home with a Urinary Catheter
Your provider may send you home with a urinary catheter if you cannot urinate on your own yet. The catheter is a tube that drains urine from your bladder into a bag. You will be taught how to use and care for your catheter before you go home.
You may also need to do self-catheterization.
- You will be told how often to empty your bladder with the catheter. Every 3 to 4 hours will keep your bladder from getting too full.
- Drink less water and other fluids after dinner to keep from having to empty your bladder as much during the night.
When to Call the Doctor
Call your provider if you have:
- Severe pain
- Fever over 100°F (37.7°C)
- Heavy vaginal bleeding
- Vaginal discharge with an odor
- A lot of blood in your urine
- Difficulty urinating
- Swollen, very red, or tender incision
- Throwing up that will not stop
- Chest pain
- Shortness of breath
- Pain or burning feeling when urinating, feeling the urge to urinate but not being able to
- More drainage than usual from your incision
- Any foreign material (mesh) that may be coming from the incision
Hartigan SM, Chapple CR, Dmochowski RR. Retropubic suspension surgery for incontinence in women. In: Partin AW, Dmochowski RR, Kavoussi LR, Peters CA, eds. Campbell-Walsh-Wein Urology. 12th ed. Philadelphia, PA: Elsevier; 2021:chap 123.
Paraiso MFR, Chen CCG. The use of biologic tissue and synthetic mesh in urogynecology and reconstructive pelvic surgery. In: Walters MD, Karram MM, eds. Urogynecology and Reconstructive Pelvic Surgery. 4th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 28.
Wagg AS. Urinary incontinence. In: Fillit HM, Rockwood K, Young J, eds. Brocklehurst's Textbook of Geriatric Medicine and Gerontology. 8th ed. Philadelphia, PA: Elsevier, 2017:chap 106.
Last reviewed on: 1/10/2021
Reviewed by: Kelly L. Stratton, MD, FACS, Associate Professor, Department of Urology, University of Oklahoma Health Sciences Center, Oklahoma City, OK. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.