What to Ask About Incontinence Surgery

Incontinence is a term used to describe the inability to control the normal processes of urination or defecation. Various options are available to treat both urinary and fecal incontinence, including medications and physical and behavioral therapy. In some cases, physicians may recommend surgery as an incontinence treatment. Prior to any such procedure, patients should have a clear understanding of the reasons for surgery, as well as the surgical methods used and their likelihood of success.

Questions Regarding the Need for Surgery

• The first thing you may want to ask your doctor is his specific reason for recommending surgery. With the wealth of nonsurgical treatments available, it is possible than a less-invasive approach may significantly help your incontinence symptoms. According to the Mayo Clinic, surgery for urinary incontinence should generally be considered when more conservative treatments have failed. Surgery may be needed to address fecal incontinence when certain underlying conditions are present, including rectal prolapse or anal sphincter damage in the aftermath of childbirth.

Questions About Potential Procedures

• Once the need for surgery is established, ask your doctor and surgeon what treatment options are available for your particular condition. For cases of urinary incontinence, common options include the implantation of an artificial urinary sphincter, sling procedures that create a hammock-like structure to hold your bladder and urethra in a better position, and a procedure called bladder neck suspension. Common surgical options for fecal incontinence include anal sphincter repair, implantation of an artificial sphincter, transplant of a muscle to strengthen your sphincter, and procedures to repair rectal prolapses or hemorrhoids. In extreme cases, your fecal incontinence can be resolved with surgery to divert your stool to an external holding device called a colostomy bag. Make sure you understand why your doctor and surgeon recommends a certain procedure, then ask him to explain that procedure in greater detail.

Questions About Preparing for Surgery

• Once a procedure is chosen, ask your surgeon what preparations you need to make in advance of surgery. Potential steps here may include reporting the use of certain medications, temporary stoppage of medications that may interfere with surgical treatment, and temporary fasting to avoid the presence of fecal matter in your colon or rectum during fecal incontinence surgery. You will also want to know how long surgery will take, and what preparations you should make for travel and for any hospital stay.

Questions About Your Surgery and Recovery

• Ask your surgeon what to expect during the surgery itself, as well as during post-operative recovery. Potential points of discussion here include anesthesia use, surgical discomfort and what to expect when you awaken after your procedure. You will also want to ask your doctor how much pain to expect after surgery, and how that pain will be treated.

  Finally, ask your doctor what to expect long-term from your procedure. Potential subjects here include the benefits of surgery, the chances of side effects or complications, and whether or not surgery may negatively affect your quality of life. You will also want to know whether the effects of your procedure are permanent, or whether other follow-up procedures may be needed.