Precautions regarding stress incontinence after minimally invasive sling surgery

With the gradual popularization of minimally invasive surgical TVT sling procedure for urinary incontinence, more and more female stress incontinence patients are undergoing mid-urethral suspension, which is currently the most effective (success rate of more than 95%) and safe treatment for female stress incontinence, despite the fact that there are fewer postoperative complications and low side effects, many patients are not well informed about the general postoperative management and precautions, and I would like to combine my own With my clinical experience, I would like to briefly introduce the postoperative management and follow-up after midurethral suspension for female stress urinary incontinence. 1. Usually, the hospitalization 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 oozing blood and whether they have scabbed over, and remove the gauze and urinary catheter that are filled into the vagina, and advise the patient to drink more water. 2. 2. After the first time of urination, the patient should find out 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 cases, it is recommended to do an ultrasound residual urine examination. 3. According to our experience, about less than 1% of patients may experience dysuria after surgery, which is related to postoperative urethral edema, and can be treated with oral a-blocker medication, which can significantly relieve dysuria. If still not relieved, can be given about 1 week of indwelling urinary catheter, reduce urethral edema, through this method, the general patient’s symptoms can be relieved. 4. Postoperative discomfort and pain may occur at the puncture point, mostly related to local hematoma and sling pulling, hot compresses can significantly reduce the pain, usually 1-2 months will be relieved. 5. The patient should return to the hospital for follow-up 2 weeks after discharge, which includes vaginal examination to understand the wound healing status, and measurement of urine flow rate and residual urine volume to understand whether there is any urinary dysfunction. 6. After mid-urethral suspension surgery, patients who have urinary tract infection or unexplained hematuria should be examined in time to exclude erosion of the sling and rejection. 7. Some patients may experience urinary frequency and urgency after surgery, which may be related to the irritation of the urethra or bladder base by the sling. Generally, these 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 urinary frequency and urgency. 8. Avoid coitus for 1 month after surgery to prevent the vaginal wound from splitting. 9. Patients are asked not to have heavy physical activities for 2 months after surgery. After 2 months, the sling will not usually slip off again due to the connective tissue embedded in the sling.