Surgical Options

What is Minimally Invasive Sling Procedure?

Stress urinary incontinence is the inability to control the flow of urine, which leads to the leakage of urine when you sneeze, cough or laugh. Vaginal sling is a minimally invasive surgery performed to treat stress urinary incontinence.

Conventional sling: Sling made of body tissue or synthetic material, which is secured with stitches.
Tension-Free sling: A mesh sling, which is held in place with the surrounding tissue.
The MiniArc Precise Single-Incision Sling system is a mid-urethral sling that is used to treat female urinary incontinence. It offers more accurate delivery and control. It is quite safe and is a minimally invasive procedure that has minimal risk of tissue injury and bleeding.

The procedure is performed under general or spinal anaesthesia. Dr Alexander makes a small incision inside your vagina and under the urethra. A catheter is inserted into your bladder to drain urine.

The sling is passed through the incision and secured under the urethra. This helps in lifting and supporting urethra and bladder neck (where urethra meets the bladder). You may be discharged from the hospital on the same day or you may have to stay for 1 or 2 days after the surgery.

Possible Complications with Sling Procedures

As in all surgical procedures, sling procedure may also be associated with certain complications, which include:

Break down of the artificial material of the sling (long term)
The synthetic material of the sling can be rejected by the vagina tissue (long term)
Damage to the bladder, urethra or vagina, bleeding (during procedure)
Irritation in the bladder (long term)
Voiding dysfunction

Tension Free Vaginal Tape

Tension-Free Vaginal Tape (TVT) placement is a procedure employed to control stress urinary incontinence caused by sagging of the urethra.

What is Stress Incontinence?

Stress incontinence refers to the leakage of small amounts of urine during physical movement such as coughing or laughing that suddenly increases the pressure over your urinary bladder.

About the Procedure

TVT placement is a relatively simple procedure requiring a short hospital stay with a quick recovery compared to retropubic suspension surgery.

The TVT provides support to the sagging urethra so that it remains closed during coughing or sudden movement, preventing the accidental leak of urine.

Inserting a TVT usually takes about 30 minutes and is performed under general or local anaesthesia. Dr Alexander will make small incisions over your abdomen and vaginal wall.

A mesh tape is then passed under the urethra, like a hammock, to maintain its normal position. No stitches are required to keep the TVT in place.

Recover After Tension-Free Vaginal Tape Procedure

Patients undergoing TVT placement may experience slight pain and discomfort. Following the procedure, you will be asked to empty your bladder to see the reaction of the bladder and urethra to the surgery.

Patients may go home on the same day or the next day. A catheter (thin flexible tube) may be inserted in your bladder to drain the urine during the recovery period. Patients may resume normal activities within 1 to 2 weeks. However, you may need to avoid driving for 2 weeks, and sexual activity or strenuous activities for up to 6 weeks.

The most common risks associated with TVT placement include injury to the bladder or urethra, difficulty emptying the bladder and risk of infection. The mesh tape used in the surgery may cause erosion of the pelvic tissue.

Cystoscopy

A cystoscopy is an examination of the inside of the bladder and urethra, the tube that carries urine from the bladder to the outside of the body.

Dr Alex Alexander perform the examination using a cystoscope, a long, thin instrument with an eyepiece on one end and a tiny lens and a light on the other end that is inserted into the bladder.

Dr Alex Alexander inserts the cystoscope into the patient’s urethra and the small lens magnifies the inner lining of the urethra and bladder allowing the Dr Alexander to see inside the hollow bladder. Many cystoscopes have extra channels within the sheath to insert other small instruments that can be used to treat or diagnose urinary problems.

Colposcopy

Colposcopy is a procedure in which a special magnifying instrument called a colposcope is used to look into the vagina and into the cervix. The colposcope gives an enlarged view of the outer portion of the cervix.

Colposcopy is done when there are abnormal changes in the cells of the cervix as seen on a Pap test. Further, it may be done to assess problems such as genital warts on the cervix, inflammation of the cervix, benign growths or polyps, pain and bleeding.

Tubal Reversal Reconstructive Surgery

Sterilization is a permanent method of contraception for women desiring not to become pregnant in the future. Laparoscopic technique is a minimally invasive procedure and in recent years laparoscopic sterilization has gained popularity owing to its advantages over the traditional approach. Laparoscopic sterilization is a technique of tubal ligation to block or close the fallopian tubes, the pathway for sperm to reach eggs for fertilization.

Fallopian tubes, located on either side of the uterus, pick up eggs released from the ovaries and transfer them to the uterus. If these tubes are blocked, sperm fail to reach the eggs and fertilization will not occur.

Vaginal Native Tissue Pelvic Floor Surgery

The pelvic floor is made up of pelvic muscles, ligaments, connective tissues, nerves and arteries. It contains organs such as the rectum, uterus, vagina, and bladder.