Floyd Memorial Hospital & Health Services

A frustrating and embarrassing condition that affects more than 13 million women in the United States recently got much easier to treat. Called stress incontinence, it is the involuntary leakage of urine that occurs when many women cough, laugh, sneeze or exercise. The main cause of stress incontinence is weakness in the pelvic muscles that support the bladder and the urethra, which carries urine out of the bladder. Childbirth and surgery are the most common reasons for the loss of support. Richard N. Medley, MD, a specialist in urology, is one of the few surgeons in the country who perform a new procedure that can treat this condition without anesthesia. (Another type of urinary incontinence, called urge incontinence, is usually treated with medication.)

Newest Advancement is a Great Step Forward

As Dr. Medley explained, “A very effective treatment for stress incontinence is the implantation of a tiny sling that we position under the urethra. This provides support so that when you stress the abdomen by coughing or jumping, the urethra doesn’t drop and allow leakage. There have been several generations of slings and implantation procedures developed over the years, each getting less invasive. This most recent advancement not only requires no external incisions, but also allows us to position the sling without putting the patient to sleep.”

Dr. Medley uses both the MiniArc™ Single-Incision Sling and the Gynecare TVT SECUR System. “They are similar and offer significant benefits to my patients,” he said. Advantages of the new sling procedure include the following:

• It is an outpatient procedure that usually takes only 10 to 15 minutes and requires just a tiny incision inside the vagina.
• There is very little post-operative pain, and recovery time is minimal.
• Most patients can resume normal activities within one to two weeks.

“The biggest advantage is that I can perform the procedure after using only an injection of local anesthetic,” said Dr. Medley. “I always have the option of giving sedation during the procedure if the patient needs it or is afraid. But so far, no one has needed it. With the advent of sling technology and progressive improvements in its implantation,” said Dr. Medley, “treatment has become safer and simpler than ever before. I want to make sure women know there is help and that they don’t have to suffer embarrassment or limit their activities due to stress incontinence.”

“Sling technology is well proven and has been used successfully for years to treat stress incontinence. What’s so exciting about this new procedure is that we can implant the sling in just minutes without using general anesthesia.”

-Richard N. Medley,
MD Board Certified Urologist Metropolitan Urology