Involuntary Leak of Urine
Millions of women are embarrassed by the smell from urine-stained panties. Leakage of urine upon straining can occur to various extents of stress depending on the cause and degree of the problem causing the leak. It can occur during strong coughs or when simply getting up from a lying position.
It is commonly a result of childbirth, which tends to stretch and distort connective tissues. Ageing will compound this problem and ageing itself is also a major cause because, with age, tissues become less supple and weaker.
The pelvic floor is the structure that provides support for the bladder and urinary mechanism. It is important to be armed with a set of good pelvic floor exercises (very often missed from routine exercises) that is diligently executed already in the course of pregnancy. In fact, many people fail to find the time to do exercises once the baby has arrived, so it is even more vital to perform exercises regularly and more so upon being pregnant. A set of such commonly advised exercise is known as Kegel’s.
The intact pelvic floor maintains a good angle of support for the area of exit of urine from the urinary bladder. Factors causing upset of the structural and functional relationships at this area are the cause of undesirable urine leak.
The structural relations required to keep urine from leaking can now be restored by a relatively simple mesh sling being placed at the correct location that allows the changing direction of forces on it during straining to be effective in maintaining continence.
Whilst complicated surgery was required in the past, this sling not only has better results, but can simply be inserted in a day procedure in a suitably equipped clinic minor operating theatre.
There are less complications, decreased surgical risk, rapid return to work/ activities and a good cosmetic effect. As such, more women who have been suffering in silence can now be made avail of this simpler, less expensive and more effective therapy. Further, the sling and meshes can also be used to treat genital prolapse.
Dr Alex Ooi is an Obstetrician and Gynecologist with vast experience. He has served on the Mount Elizabeth Hospital Medical Advisory Board and was Chairman of the Minimal Access (“keyhole”) Surgery group, which revamped the operating theatres and initiated educational activities in Minimal Access Surgery. He has also been a Visiting Consultant to Fudan University in Shanghai and several other hospitals in the region. He has performed many of the previous procedures for urine leakage – from open surgery and Kelly sutures to laparoscopic Burch colposuspension, and finds this sling technique a great advancement to help sufferers.
Dr Alex Ooi Koon Hean
MBBS (Singapore), MRCOG (UK), M Med (O&G)(Singapore), FAMS (O&G)
Specialty: Obstetrics & Gynaecology
Clinic: Alex Ooi & Associates OBGYN Consultants
Address: 3 Mt Elizabeth, #11-07, Mount Elizabeth Medical Centre, Singapore 228510