Minimally Invasive Surgeries for Urinary Incontinence and Pelvic Floor Disorders
Memorial Hermann offers a comprehensive array of leading-edge minimally invasive treatments for incontinence. The procedures are done on an outpatient basis, and patients can usually go home the same day. Most procedures take approximately 20 to 30 minutes and involve minimal surgical risk. Our cure rates are as high as 95 percent.
Tension-Free Vaginal Tape (TVT) Placement
TVT placement corrects stress incontinence and intrinsic sphincter defect by placing a mesh-like material under the urethra as a permanent sling. The TVT is inserted through a small vaginal incision. Patients usually return home the same day or, in some cases, stay overnight for pain control.
Transobturator Tape Placement
Less invasive than TVT, transobturator tape (TOT) placement reproduces the natural position of the pubourethral ligament. Two tiny incisions are made on the inner side of the thighs to allow for insertion of the tape. TOT provides hammock-like support for the urethra and minimizes the risk of overcorrection.
Pre-Pubic Sling Placement
Pre-pubic sling placement offers women with mild stress incontinence another treatment option. By positioning the supportive sling in front of the pubic bone, pre-pubic sling placement minimizes the risk of injury to internal organs during surgery.
Supra Pubic Arc (SPARC)
Similar to TVT in its anatomic approach, the SPARC™ system is designed to provide a safe and simple option for the placement of a sling. Thin, curved needles are inserted through two tiny incisions above the pubic bone and advanced to a vaginal incision below the urethra. The sling tension can also be adjusted to provide support to the urethra.
Collagen micro-modeling is a 15- to 20-minute nonsurgical in-office treatment that involves coagulation of the tissues at the bladder neck using radiofrequency ablation. Pain is minimal, and the procedure can be done without general anesthesia.
Injections for Urethral Bulking
Urethral bulking may be used to seal holes in the urethra through which urine is leaking or to thicken the urethral wall so that it seals tightly. Bulking materials are most often injected just outside the muscle of the urethra at the bladder outlet. Needle placement is guided by the use of a cystoscope inserted into the urethra. Materials used for urethral bulking include polytetrafluoroethylene (PTFE), bovine collagen (glutaraldehyde cross-linked bovine collagen) and Durasphere™.
This new treatment option for overactive bladder incorporates a small stimulator that is inserted in the back and delivers mild electrical stimulation to the sacral nerve. Patients report significant improvement in urgency and frequency symptoms.
We also offer traditional open surgeries for incontinence:
- Retropubic suspension
- Burch colposuspension
- Marshal-Marketti-Krantz procedure (MMK)
- Pubovaginal slings
- Artificial sphincter for patients who have not responded to other treatments
For more information about robotic-assisted surgery and minimally invasive surgery, call 713-704-2494.