Dr N Addresses Stress Incontinence

Dear Dr N- I just had a TVT procedure and i don’t wear pads anymore! I threw up in the hospital before going home and I did not leak. You are a miracle worker. I’m off to the gym and I don’t leak in the bedroom. THANKS, signed dry and happy

Dear Dry- This is one of the most rewarding procedures I do. There are so many reasons why women are prone to leaking- childbirth being the number one culprit. Sometimes risk factors add up, smoking, asthma, extra weight and lots of lifting at work. I have seen a big fall off of women coming in to get help. They seem to be fearful of the device I use thinking this is ‘the mesh’ that is advertised on the TV. The commercials have put fear in patients and I do not appreciate this form of advertising. It is not good information and is contributing to women not coming in to get help. Yes, there are patients that have had problems with mesh procedures with LARGE pieces being placed in the vagina without patients knowing risks and possible outcomes. The tvt is a small device that does not lead to the big problems which are the target of the advertising. It is like apples and oranges. Small devices, small risk. Large devices, larger risk. My hope is that women will come in and talk to their provider about the choices to solve urinary leakage. There is physical therapy, pessaries, surgeries with native tissue and then procedures using devices including small pieces of mesh with minimal risk. I recommend these procedures with an experienced surgeon and with correct patient selection who follow their surgeons postop instructions. There are retropubic, obturator, Kelly plication, native sling procedures with autologous fascia. Find a surgeon that can use many different options that fits the solution with the appropriate problem and does not have a ‘one size fits all’ philosophy about surgery. Surgery is creative and requires experience and judgement. Glad you’re happy. Spread the work 🙂 Dr N

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