Transvaginal Bladder Neck Suspension

WHAT YOU SHOULD KNOW:

Transvaginal bladder neck suspension is surgery to treat stress incontinence (in-KON-tih-nence). Stress incontinence is when urine leaks with straining. This may happen when you are lifting heavy items, coughing, sneezing, or laughing. Transvaginal means that the surgery is done through your vagina (birth canal). The goal of surgery is to move the bladder and urethra back into their correct positions. Doing this may correct stress incontinence. The bladder is the organ that holds urine before it leaves the body. The urethra is the tube that carries urine from your bladder to the outside of your body.

AFTER YOU LEAVE:

Take your medicine as directed:

Call your primary healthcare provider if you think your medicine is not working as expected. Tell him if you are allergic to any medicine. Keep a current list of the medicines, vitamins, and herbs you take. Include the amounts, and when, how, and why you take them. Take the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency. Throw away old medicine lists.

Medical appointments:

Ask for information about where and when to go for follow-up visits:

For continuing care, treatments, or home services, ask for more information.

Activity guidelines:

• You may feel like resting more after surgery. Slowly start to do more each day, and rest when you feel it is needed.
  
  
• Avoid lifting heavy objects.
  
  
• Ask caregivers when you can begin driving a car again.
  
  
• Ask your caregiver when you can return to work or school.

Bathing with stitches:

Follow your primary healthcare provider's instructions on when you can bathe. Gently wash the part of your body that has the stitches. Do not rub on the stitches to dry your skin. Pat the area gently with a towel. When the area is dry, put on a clean, new bandage as directed.

Constipation:

If you are constipated, you may have a hard time having a bowel movement (BM) Do not try to push the BM out if it is too hard. Walking is the best way to get your bowels moving. Eat foods high in fiber to make it easier to have a BM. Good examples are high fiber cereals, beans, vegetables, and whole grain breads. Prune juice may help make the BM softer. Caregivers may give you fiber medicine or a stool softener to help make your BMs softer and more regular. You can also buy these medicines at a grocery or drug store.

Foley catheter:

You may go home from the hospital with a foley catheter in your bladder. This tube drains urine from your bladder, the organ where urine is kept. The catheter may go into your urethra (the tube that goes from your bladder to the outside of your body). If the catheter is in your urethra, you may feel like you have to urinate. Relax and the catheter will drain urine for you. The catheter may be put into your bladder through an incision (cut) in your abdomen instead of your urethra. Do not pull on the catheter because this will make you hurt or bleed. Do not kink the catheter because your urine will not be able to drain. Do not lift the bag of urine above your waist. If you do this, the urine will flow back into your bladder and it may cause an infection.

Special exercises:

• Kegel exercises are done to strengthen your pelvic and vaginal muscles after surgery, and after catheter removal. These exercises can help prevent stress incontinence Kegel exercises also help decrease discomfort during pregnancy, and can make having a baby easier. They also help prevent problems that may happen to muscles in the pelvic area after having a baby. Become aware of the muscle by sitting on the toilet to urinate. Practice shutting off your urine flow by tightening your muscles. Then restart the urine flow. Do this several times.
  
  
• Once you get used to shutting off and restarting your urine flow, practice the exercise without urinating. Before getting out of bed in the morning, tighten the muscle five or ten times. Each time you sit on the toilet to urinate, practice the exercise five or ten times. Over time, increase the number of times you do the exercise to 300 times a day. You may also do the exercise while standing or sitting in a chair. This exercise should not make you feel tired. In time, the muscles will get stronger, and you will be able to have better control over when you urinate.

Wellness tips:

• Eat a variety of healthy foods: This may help you have more energy and heal faster. Healthy foods include fruit, vegetables, whole-grain breads, low-fat dairy products, beans, lean meat, and fish. Ask if you need to be on a special diet.
  
  
• Drink liquids as directed: Adults should drink between 9 and 13 eight-ounce cups of liquid every day. Ask what amount is best for you. For most people, good liquids to drink are water, juice, and milk.
  
  
• Get plenty of exercise: Talk to your caregiver about the best exercise plan for you. Exercise can decrease your blood pressure and improve your health.
  
  
• Do not smoke: If you smoke, it is never too late to quit. You are more likely to have heart disease, lung disease, cancer, and other health problems if you smoke. Quitting smoking will improve your health and the health of those around you. If you smoke, ask for information about how to stop.
  
  
• Manage stress: Stress may slow healing and cause illness. Learn new ways to relax, such as deep breathing.

CONTACT A CAREGIVER IF:

• You have a fever.
  
  
• Your stitches come apart.
  
  
• Your bandage becomes soaked with blood.
  
  
• The skin around your stitches is red, swollen, or has pus coming from the incision (cut).
  
  
• You have chills, a cough, or feel weak and achy.
  
  
• Your skin is itchy, swollen, or has a rash. Your medicine may be causing these symptoms.
  
  
• You have questions or concerns about your surgery, medicine, or recovery.

SEEK CARE IMMEDIATELY IF:

• You have chest pain or trouble breathing.
  
  

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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