Spire Harpenden Hospital provides subspecialist services in urogynaecology to patients from Hertfordshire, Bedfordshire, Buckinghamshire, London and the surrounding counties. We cater for women with urinary incontinence and prolapse conditions. The services are provided by a subspecialist team of consultant surgeons who provide the latest and most modern minimal access surgical techniques available for the treatment of prolapse and incontinence.
What is Urinary Incontinence?
Urinary incontinence is a common and embarrassing problem that affects many women following childbirth or undergoing the change. Although many women suffer in silence, expert help is available in relaxed comfortable surroundings at Spire Harpenden Hospital. Initial treatments of urinary incontinence include pelvic floor physiotherapy, reduction of caffeinated drinks and bladder retraining.
What are the types of incontinence?
There are two main types of urinary incontinence; the first is stress urinary incontinence, where urinary leakage occurs with activity. The second is bladder overactivity incontinence. Stress urinary incontinence is caused by alteration of the continence mechanism, which can happen due to age or childbirth. It is associated with urinary leakage during activity, coughing and sneezing. The second type of urinary incontinence is associated with bladder overactivity. This type of incontinence is typically associated with feeling of urinary urgency (a sudden compelling desire to pass urine which is difficult to defer) and the constant need to pass urine during day and night.
What is Urodynamic Testing?
Urodynamcis is a simple test that is done to diagnose the cause of urinary incontinence and test the strength of bladder muscle to achieve normal voiding. It is a simple test that takes around twenty minutes to do and involves inserting a small tube into the bladder to fill the bladder with saline (salt water) and a small tube into the vagina or occasionally the back passage. The bladder is then filled with saline and the pressure inside the bladder is measured throughout with the computer attached to the bladder tube. You will then be asked to cough and sneeze to assess the exact cause of urinary leakage. The final stage involves emptying your bladder into an electric loo which measures the strength of your bladder wall muscles. Based on the results of the test, a decision will be made regarding surgery.
What is the surgical treatment of stress incontinence?
Surgical treatment of urinary incontinence depends on the type of incontinence. A diagnosis is normally made with a test called urodynamics. This is a simple test that takes around twenty minutes to do to assess the strength of the continence mechanisms in the bladder and the function of the bladder wall muscle. Modern treatments of urinary incontinence include inserting the tension free vaginal tape in the vagina. This is a simple procedure that could be done as a day-case, with only two tiny cuts in the lower abdomen, and more than 80% success rate.
Are there less invasive treatments available for the elderly?
Urinary incontinence affects all age groups but tends to be much commoner in the elderly population. The tape procedure may be inappropriate for elderly ladies, especially with medical conditions. We offer a minimally invasive procedure to treat urinary incontinence under local anaesthetic using bulking agents of the bladder neck. The procedure takes around fifteen minutes and patients can go home on the same day.
What is the treatment of overactivity incontinence?
The treatment of this condition is generally medical, by the use of tablets called anti-muscarinics and bladder retraining including cutting down on caffeinated drinks. If the tablets fail to improve the symptoms, then surgical intervention is needed to treat the overactivity.
What is the surgical treatment of overactivity?
Overactive bladder resistant to treatment with medical therapy can be easily treated nowadays with injections of botulinium into the bladder wall. This is a short procedure done through a small telescope into the bladder, with no cuts involved. This can also be performed as a day procedure. Spire Harpenden Hospital is among few providers of private healthcare offering patients this treatment for overactive bladder.
Vaginal prolapse is a common condition that affects many women following childbirth and can have a significant impact on patient’s quality of life. Many patients feel embarrassed about the prolapse and probably are not aware that modern minimally invasive treatments exist for this common condition.
What are the best treatments for vaginal and uterine prolapse?
Prolapse can be treated using a small device (a pessary) inserted into the vagina. For the majority of women, this is a temporary measure as many patients feel that they would like more permanent solution to their prolapse. Surgical options include vaginal repairs or prolapse repair using key-hole surgery. In some women, the use of strengthening vaginal mesh is needed to support the prolapse. In addition, we provide the unique expertise of suspending the uterus using key-hole surgery instead of hysterectomy for women with prolapse of the womb.
What if I had a hysterectomy and the prolapse came back?
In many women, this condition is described as vaginal vault prolapse, where the top of the vagina protrudes through the vaginal opening. The best treatment for this condition includes suspension of the top of the vagina with mesh using key-hole surgery. This is a specialist service provided at our hospital and has the main advantage of quicker recovery and return to normal activity along with smaller (more cosmetic) scars.
What if I had a previous prolapse repair and the prolapse came back?
The best treatment option for this condition (recurrent prolapse) is prolapse repair using mesh. Through our subspecialist team, we offer the unique expertise of providing this service to women with recurrent vaginal prolapse.
To find out more about urogynaecology services at Spire Harpenden Hospital call 01582 714420 or email us at firstname.lastname@example.org