Surgery Options for Women With Postpartum Bladder Problems

Women experience urinary incontinence or leakage twice as often as men, because of the effects of childbirth, pregnancy, menopause and anatomical differences in the urinary tract, according to the National Kidney and Urologic Diseases Clearinghouse. Childbirth can weaken the internal structures that support your bladder, causing urine leakage when you exercise, cough, laugh, sneeze or bend. Postpartum bladder problems that don't respond to other forms of treatment can be successfully treated with surgery.

Sling Surgery

• Suburethral sling surgery might be recommended if your urethra is not in the proper position or the urethral sphincter muscle is weak. The urethra is the tube that carries urine from the bladder to the exterior opening in the skin. During surgery, the sling is placed under the urethra, providing additional support for the bladder and urethra. The sling might be made of a synthetic mesh material or your own tissue and might be adjustable.

  Surgery can be performed using an open surgical procedure or through a minimally invasive laparoscopic procedure. If you have laparoscopic surgery, several small cuts will be made in your abdomen and vagina. Your doctor will pass a thin tube containing a miniature camera and surgical instruments through these openings.

Bladder Neck Suspension Surgery

• Bladder neck surgery might be helpful if the neck of your bladder has dropped following childbirth. An incision is made in your abdomen during this open surgical procedure, which requires general or spinal anesthesia. Stitches are placed in the bladder neck, connecting it to the pubic bone ligament or the pubic bone cartilage. Stitching the bladder neck to either of these structures reinforces the urethra and bladder neck, preventing sagging.

Recovery

• Your recovery will vary depending on whether you have an open or laparoscopic surgical procedure. You will have a shorter recovery period if you have laparoscopic surgery. Expect to experience some degree of pain or discomfort for a few days to a few weeks after surgery. Over-the-counter and prescription pain medications can help relieve pain. In some cases, urination might be difficult following surgery and you might need to temporarily use a catheter to help you urinate. A catheter is a thin tube that is inserted through the urethra into the bladder, allowing the bladder to drain. You might notice some blood in your urine after surgery. This is normal, but you should contact your doctor if bleeding continues after a few days or if the bleeding is heavy.

  It might take some time for your bladder to get used to its new position and you might experience bladder spasms as a result. As the bladder heals, the spasms will stop. Your doctor can prescribe medication to help control the spasms, if needed. During your recovery period, you should avoid heavy exercise and lifting or straining when you have a bowel movement. You should not have sex, use tampons or douches, or insert anything into your vagina for six weeks after surgery, according to the American Congress of Obstetricians and Gynecologists.

  Rare complications of surgery include infections and the inability to urinate without catheterization. Surgery to remove the sling or the stitches holding it in place might be needed to remedy the problem.