Precautions regarding stress urinary incontinence after minimally invasive sling surgery

     With the gradual popularity of the minimally invasive surgery TVT sling for urinary incontinence, more and more female patients with stress urinary incontinence are receiving midurethral suspension, which is currently the most effective (success rate of more than 95%) and safe treatment method for female stress urinary incontinence, although there are few postoperative complications and low side effects, many patients do not know much about postoperative general management and precautions, I combine my I combine my clinical experience to briefly introduce the treatment and follow-up after midurethral suspension for female stress urinary incontinence. Urology Department of Shanghai Renji Hospital, Lu Jianwei 1. Usually, the hospital stay for TVT surgery is only 2-3 days. On the second day after surgery, we need to check whether the puncture wounds on both sides of the patient are bleeding and whether they have crusted over, and remove the gauze and urinary catheter filled into the vagina and ask the patient to drink more water.    2. After the first urination, we should check whether there is any difficulty in urination and whether there is any obvious thinning of the urine line, and if there is any of the above, we suggest to do an ultrasound residual urine examination.    3. In our experience, less than 1% of patients may experience dyspareunia after surgery, which is related to postoperative urethral edema, and can be treated with oral a-blocker medication, which can significantly relieve dyspareunia. If it is still not relieved, an indwelling urinary catheter can be given for about 1 week to reduce urethral edema, and the symptoms of patients can be relieved by this method in general.    4. Postoperative discomfort and pain may occur at the puncture site, mostly related to local hematoma and sling pulling, and hot compresses can significantly reduce the pain, which will generally be relieved in 1-2 months.    5. Patients should return to the hospital for follow-up 2 weeks after discharge, which includes vaginal examination to understand the wound healing, urinary flow rate and residual urine volume measurement to understand whether there is any phenomenon of urinary dysfunction.    6. Patients who develop urinary tract infection or unexplained hematuria at any time after mid-urethral suspension should be examined promptly to exclude sling erosion and excretion.    7. Some patients may experience urinary frequency and urgency after surgery, which may be related to the irritation of the urethra or the bottom of the bladder by the sling. Generally such symptoms will disappear about 1 month after surgery. If the symptoms persist, M-blockers can be taken once a day, one tablet each time, which can effectively relieve the frequency and urgency of urination.    8. Avoid intercourse for 1 month after surgery to prevent the vaginal wound from opening.    9. Patients are requested not to have heavy physical activities for 2 months after surgery. After 2 months, the sling will not usually slip again because the connective tissue is embedded in the sling.