Patient: Description of the condition (time of onset, main symptoms, hospital visited, etc.): The patient is female, 52 years old, in good health and not menopausal. The condition is as follows: 1. the disease has lasted for 2-3 years; 2. the urine flows when sneezing, walking or even when sitting or standing normally; 3. it is especially severe in the days after menstruation. Thank you very much! Yang Yong, Department of Urology, Beijing University Cancer Hospital
Yang Yong, Department of Urology, Beijing Chaoyang Hospital: Coughing and leaking urine is stress urinary incontinence, stress urinary incontinence is a non-fatal disease that mainly affects the quality of life of patients, the main means of treatment is surgery, for two reasons, one is that there is no long-term effective and curable drug treatment for stress urinary incontinence, and the second is that the current surgery for stress urinary incontinence is minimally invasive and very effective. Since the disease mainly affects the patient’s quality of life, the decision to operate depends in most cases on the patient’s wishes. Our experience is that if the disease changes the patient’s lifestyle, surgery is recommended. In your case, we estimate that you need to wear a sanitary napkin every day or you wet your pants, and in this case we consider that the disease has changed your lifestyle. The procedure is done mainly through a vaginal incision (about 1.5 cm), punctured and a sling is placed under the urethra. The procedure is minimal and takes about 15-20 minutes. Three days after the surgery, you can go about your daily activities (including going to work). For three months after the surgery, you should not engage in heavy physical activities, such as playing ball or splits, which may cause the sling to loosen. After three months, the sling and the tissues are completely fused and you can resume any activities you had before surgery. The cost of the surgery depends on the type of sling. The traditional sling is TVT-O, with a disposable consumable charge of RMB 6,000, which is reimbursed by 70% of Beijing’s medical insurance and RMB 1,800 at your own expense, and all other costs are reimbursed by medical insurance, with a total cost of about 12,000 (including the total cost of consumables for the sling of RMB 6,000); the newer sling is called TVT-S, with a disposable consumable charge of RMB 16,000, which is also reimbursed by 70% of Beijing’s medical insurance and RMB 4,800 at your own expense. 4800 RMB; all other costs are reimbursed by medical insurance. The efficacy of the two procedures is basically the same, but the new sling does not have temporary postoperative leg pain because it does not come out of the thigh according to the puncture, while most patients have pain at the root of the thigh within 3 weeks after the former procedure, and very few patients have leg pain that lasts for several months.