Dr Jo Schoeman
Urological Surgeon

        

Service List 12

Incontinence Surgery

Obturator Sling Incontinence Procedure

This is a procedure for female incontinence. A small synthetic tape is placed through the obturator foramen (inner thigh) and placed securely below the mid urethra to support it during straining. An overactive bladder needs to excluded prior with Urodynamic Studies.

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Retropubic Sling Incontinence Procedure

This is a slightly more invasive technique of placing the same synthetic tape below the urethra. The difference is that the exit wounds are above the pubic bones. There is a higher risk of complications, yet is better for the ladies with intrinsic deficiency.

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Macroplastique Peri-urethral injections

For those ladies where a sling procedure or even a retro-pubic Birch colposuspension has failed due to intrinsic Sphincter Deficiency. These injections bolster up the urethra leading to better closure. The substance may migrate and may require more than one procedure.

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Cystocoele Repair (Natural)

For bladder prolapse repair. Usually occurs in middle age women with prolonged labour, ageing and tissue laxity as causative agents.

This can be repaired with Mesh (for the sexually inactive) Porcine dermis Native vaginal tissue (Natural).

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Cystocoele Repair (Surgisis)

For bladder prolapse repair. Usually occurs in middle age women with prolonged labour, ageing and tissue laxity as causative agents.

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Cystocoele Repair (Elevate Synthetic)

For bladder prolapse repair. Usually occurs in middle age women with prolonged labour, ageing and tissue laxity as causative agents.

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Colpocleisis

Permanent closure of the vagina in the elderly who suffer from pelvic organ prolapse and who aren't and never will be sexually active.

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Valut Repair Sacro Colpo-pexy

For those ladies where the whole vault has prolapsed. She may even have a completely prolapsed everted vagina on the outside of her vaginal orifice. This is an open surgical procedure where the vault of her vagina is fixed to the sacrum inside, therefore securing the vagina in its normal position.

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Birch Colposuspension

Main incontinence surgery for ladies in the previous millennium. Open retropubic procedure with merits in a handful of patients. Same success rates as the Sling procedure, yet more invasive.

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Male Advance Sling

For those guys who suffer persistent low-intermediate grade of stress incontinence after their radical prostatectomy for prostate cancer. Done on the same principles of the TVT-O sling, yet more invasive.

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Sacroneuro Modulation

Surgical placement of a nerve stimulator or pacemaker in the S3 foramina. 2 staged procedure. Indicated for overactive bladdera, underactive floppy bladders and lastly chronic pelvic pain.

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Intravesical Botox

Endoscopic procedure where Botox is injected into the Neurogenic and non-neurogenic (overactive bladder) to relief the urgency and frequency. Dosages vary from condition to condition. Can be associated with urinary retention in patients using larger doses of Botox. Effects only last up to 9 months.

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