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:

Medicines:

• Keep a written list of the medicines you take, the amounts, and when and why you take them. Bring the list of your medicines or the pill bottles when you see your caregivers. Learn why you take each medicine. Ask your caregiver for information about your medicine. Do not use any medicines, over-the-counter drugs, vitamins, herbs, or food supplements without first talking to caregivers.
  
  
• Always take your medicine as directed by caregivers. Call your caregiver if you think your medicines are not helping or if you feel you are having side effects. Do not quit taking your medicines until you discuss it with your caregiver. If you are taking medicine that makes you drowsy, do not drive or use heavy equipment.

Medical appointments:

Ask your caregiver when to return for a follow-up visit. Keep all appointments. Write down any questions you may have. This way you will remember to ask these questions during your next visit.

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: When you are allowed to bathe or shower, carefully wash your stitches or staples with soap and water. Afterwards, put on a clean, new bandage. Change your bandage any time it gets wet or dirty. If you cannot reach the bandage, ask someone else to help you change it. You may have steri-strips (thin strips of tape) on your incision. Keep them clean and dry. As they start to peel off, let them fall off by themselves. Do not pull them off.

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 hints:

• Eating and drinking:
  
  
  • Eat a variety of healthy foods such as fruits, vegetables, whole-grain breads, low-fat dairy products, beans, lean meat and fish. Eating healthy foods may help you have more energy and heal faster. Ask your caregiver if you need to be on a special diet.
    
    
  • Men 19 years old and older should drink about 3.0 Liters of liquid each day (close to 13 eight-ounce cups). Women 19 years old and older should drink about 2.2 Liters of liquid each day (close to 9 eight-ounce cups). Follow your caregiver's advice if you must change the amount of liquid you drink. For most people, good liquids to drink are water, juices, and milk. If you are used to drinking liquids that contain caffeine, such as coffee, these can also be counted in your daily liquid amount. Try to drink enough liquid each day, and not just when you feel thirsty.
  
  
• Start exercising: Talk to your caregiver before you start exercising. Together you can plan the best exercise program for you. It is best to start slowly and do more as you get stronger. Exercising can help make your heart stronger, lower your blood pressure, and keep you healthy.
  
  
• Quit smoking: It is never too late to quit smoking. Smoking harms the heart, lungs, and the blood. You are more likely to have a heart attack, lung disease, and cancer if you smoke. You will help yourself and those around you by not smoking. Ask your caregiver for more information about how to stop smoking if you are having trouble quitting.
  
  
• Avoid stress: Stress may slow healing and cause illness. Since it is hard to avoid stress, learn to control it. Learn new ways to relax, such as deep breathing. Talk to your caregiver about things that upset you.

CONTACT A CAREGIVER IF:

• You have a fever (increased body temperature).
  
  
• 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.
  
  

Copyright © 2008 Thomson Healthcare Inc. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

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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