Sling procedure for urinary stress incontinence

While it is most common to go to one's ob/gyn for these procedures, dear wife and I chose to go to our family urologist for help with her situation. Two reasons for this. First, he has exhibited wonderful competence and caring over the two years I have been seeing him and one of his areas of interest is female stress incontinence. Second, ob/gyns in the US tend to yank out the uterus and ovaries of post menopausal women "because you don't need them any more". This, of course, is utter rubbish.

I would be interested in hearing anyone's experiences in this regard or the opinions of members toward our preference in this case.

Speed

Yes, indeed, for the last four years or so, ever since the problem started, she has done her Kegels and the other exercises suggested. They may or may not have helped some. The basic problem is exactly what the tension free slings are designed to correct - hypermobility of the urethra.

Our urologist of has done 397 of the exact procedure he will be performing on dear wife with over 97% of his patients reporting dry and all but three reporting improvement. This is because, I imagine, he has very good technique.

I cannot trust a gynocologist in the US to do this procedure as they do so many unnecessary hysterectomies; 618,000 in 2006 of which only 30,000 involved cancer of the uterus and or ovaries. That is unacceptable.

The surgical release basically gives a surgeon the right to do whatever he wants once he opens you up. In most states, this release gives the patient no relief if the doctor does a procedure that you do not desire, even if you specifically tell him that he is not to do it. That sucks.

Speed

My wife recently had a monarc sling procedure. She used a gyn doc who specialized in uro procedures. What was most important was that the doc was certified in the procedure. Because insurance companies dont want to pay for unnec. procedures, it is less likely that any doc is going to remove anything that doesn't need removing. My wife, whose a real doc, didn't use a urologist because in the States, most urologist spend the majority of their time on male patients and generally have less experience doing slings.

That is fine, that she survived the surgery with her female organs intact. I repeat what I said, though. Well over 600,000 hysterectomies are performed in the United States each year. Most of these are unnecessary as their are alternative procedures and treatments. The fact is that the insurance payment structure actually encourages these unnecessary procedures as most policies pay considerably more for hysterectomy than for procedures to ablate fibroids, for example.

Speed

There was a video I watched on yahoo videos about this. I can't remember what it was but I am sure you could find it.

Somewhere on this site I recently picked up the following link. Its audio is in the French language but easy to follow the procedure which is known as Trans-Vaginal Tape or TVT.

The operation is somewhat eye watering to watch as its done using local anaesthesia and sedation but the lady patient appeared quite content, chatting to the anaesthetist.

http://www.canal-u.tv/producteurs/canal_u_medecine/dossier_programmes/urologie/film/cure_d_incontinence_urinaire_sous_anesthesie_locale_et_en_ambulatoire_par_le_procede_tvt

Mine was done by a gynecologist but my GP thought I should have used an urologist. I think you made the right choice. I must just add that the gyne did an excellent job in my case.