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Failed Bladder Treatments No More: An “adjustable” option offers new hope for patients wanting an end to urinary incontinence

adjustable bladder slingLike many of her friends, Alice Bird thought she would have to live the rest of her life constantly planning for a bladder leakage episode, changing two to three absorbent pads every day.

The 73-year-old had been dealing with the embarrassing chronic condition of urinary incontinence (the loss of bladder control) for the past three years, a problem that as many as 30 million Americans—mostly women—face in varying severity as they age. Multiple pregnancies, hysterectomy, obesity and an “overactive bladder” all put women at risk for the condition.

Bird had seen several physicians about her condition near her Elgin home. At first, doctors advised a hysterectomy with a bladder sling to correct the condition. But months later the problem returned.

Then her physician suggested urethral injections, which added bulk to the urethra to keep the passageway firm. This was another failed attempt.

Then Bird visited Charles Feinstein, M.D., urologist and urogynecologist at Weiss Memorial Hospital. He’s the first and the only physician in the Midwest offering the adjustable bladder sling procedure, performed on patients who have not found success with a primary bladder sling.

For most sufferers, a primary bladder suspension (sling) surgery is effective in relieving symptoms. Some 180,000 of these operations were done last year for urinary incontinence, and another 300,000 surgeries for bladder and pelvic prolapse, but a number of these procedures fail.

“Ten percent of these bladder sling procedures don’t correct the problem,” Dr. Feinstein said. “We’re talking about 18,000 women nationwide who think there’s no hope in treating their condition, but there is.”

In a primary bladder sling procedure, the treatment of choice, a mesh-like material is placed under the urethra through one vaginal incision and two small abdominal incisions, creating a hammock of support. But in a tenth of the cases, the tension of the sling isn’t tight enough to prevent leakage.

For the past two years, Dr. Feinstein has been performing the minimally invasive adjustable bladder sling procedure, which started in Barcelona, Spain. “It’s an extraordinary option,” he said. “It exactly measures, adjusts and fixes the problem.”

There’s a 99 percent success rate. The minimally invasive procedure works by placing an adjustable “screwdriver” through the belly and attaching it to the top of a mesh “sling” positioned under the bladder. A day after the procedure, Dr. Feinstein adjusts the sling’s tension using the “screwdriver” to achieve proper bladder control. Adjustments can continue to be made months or years later and require only a local anesthetic to access the adjustable portion. The treatment prevents multiple surgeries to cure the urinary incontinence, reducing risk, cost and time for the patient.

Extensive testing is done before and after the procedure. Ultrasound and CMG (cystometrographic) equipment are available for the most accurate diagnostic evaluations of all incontinent patients.

After having the adjustable bladder sling put in and the “screwdriver” turned more than 40 times,
Bird is thankful she found a treatment option that doesn’t have her wearing pads anymore.

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