FEEL FREE TO LAUGH AGAIN - STOP THE LEAK IN 10 MINUTES ( THE LATEST SURGERY )

Stress Urinary Incontinence ( SUI ) is the uncontrollable leakage of urine on exertion, such as running, jumping, sneezing, laughing and coughing. Associated causes include child-birth, menopause, obesity, chronic lifting of heavy loads, chronic cough and constipation.

A national survey on 3500 females in Singapore by Dr Christopher Chong revealed that 13.5% sufferred from SUI and a shocking 35.6%in the above 50 age group; that is more than 1 out of 3 females above 50 years old suffer from SUI. This equates to about 190 000 females in Singapore. It is estimated that less than 30 000 have seeked treatment for this problem. Also from the survey, the reasons for this low treatment level were that majority of the females were too embarassed to talk about it ( even with close friends or relatives ), did not know that it is a problem, did not know that it can be treated, and did not know where to seek treatment. Many, sadly, accepted it as part of growing old.

The Tension-free Vaginal Tape ( TVT ) is now the accepted surgery of choice in the treatment of SUI. The latest technique using the same tape is called TVT_O ( TVT-Obturator ) and has been used in Singapore for more than a year. It uses a polypropylene mesh tape placed around the middle part of the baldder neck ( " door " or outlet pipe of the bladder ) without any tension or stitches. The exit point is not through the abdomen but through the inner thigh. When a person strains, the bladder neck pushes onto the tape and closes, thus preventing leakage of urine. This tape is left permanently in the body.

The new technique has advantages over the older ones in that there is less risk of bleeding and injury to the bladder, and cystoscopy ( putting a TV system into the bladder ) to check for bladder damage and perforation need not be routinely done. This surgery can be done as a day procedure and the patient can be up and about the same day.

Complications, though minimal, include voiding problem ( less than 1% ), erosion of the mesh through the vagina, infection, bleeding, bladder injury and thigh pain.

In my personal series of the first 100 cases, the short-term success rate is 94%.

People with SUI should seek treatment early. A Screening ( to check if one is prone to or has SUI ) and Prevention Clinic for SUI is available so as to tackle the problem early in order to prevent progression to surgery. This is important as the more severe the condition, the lower the suceess rate from surgery.

There are many surgeries for SUI, ranging from 30 - 40% success rate for some old surgeries, to over 90% for some newer ones. Hence, it is very important to select the correct and best surgery for SUI. This is especially so as the success rate for SUI surgery fall with each subsequent surgery.

It is mandatory to perform a computer test of the baldder, called URODYNAMICS STUDIES, before any incontinence surgery in order to select the best and correct surgery for the patient. Life expectancy has gone up to 81 - 83 and people now have many more good years to live.

Ladies, do not suffer in silence for a lot can be done to improve or cure the problem of urinary leakage. On top of the" 5Cs " that people strive towards, we should add one more " C " . . . . . CONTINENCE.