Our Summary

This study looked at the effectiveness of bladder neck needle suspension, a surgery for women with moderate or severe urinary incontinence. This is a common condition, affecting about a third of adult women. The researchers compared the results of this surgery with other treatment options. They found that the needle suspension surgery was more likely to fail than another procedure called open abdominal retropubic suspension. However, it might be as effective as a procedure called anterior vaginal repair. The study could not conclusively compare the needle suspension surgery with some other treatments, including suburethral slings, because the data was either insufficient or came from a small, non-representative group. The researchers concluded that bladder neck needle suspension surgery is probably not the best option for treating urinary incontinence due to its lower success rates. However, they also noted that the evidence was not very reliable due to the poor quality and small size of the trials reviewed. They also mentioned that no cost-effectiveness studies had been done comparing this surgery with other options.

FAQs

  1. What is bladder neck needle suspension surgery and who is it for?
  2. How does bladder neck needle suspension compare to other treatments for urinary incontinence in women?
  3. What limitations did the researchers face when comparing bladder neck needle suspension surgery to other treatments?

Doctor’s Tip

A doctor might advise a patient considering bladder surgery to thoroughly discuss all treatment options with their healthcare provider, including potential risks and benefits. It is important to ask questions and seek a second opinion if needed. Additionally, following post-operative instructions, attending follow-up appointments, and maintaining a healthy lifestyle can help optimize recovery and long-term success.

Suitable For

Bladder surgery is typically recommended for patients with moderate to severe urinary incontinence that does not improve with non-surgical treatments such as medication, physical therapy, or lifestyle changes. Patients who may benefit from bladder surgery include those with stress incontinence (leakage of urine during physical activities such as coughing, sneezing, or exercising), urge incontinence (sudden and strong need to urinate with leakage), mixed incontinence (combination of stress and urge incontinence), or other bladder or pelvic floor disorders.

It is important for patients to discuss their symptoms and treatment options with their healthcare provider to determine if bladder surgery is the best course of action for their individual situation.

Timeline

  • Before bladder surgery:
  1. Patient experiences symptoms of urinary incontinence, such as leaking urine when coughing, sneezing, or laughing.
  2. Patient consults with a healthcare provider to discuss treatment options.
  3. Healthcare provider recommends bladder surgery as a potential treatment option.
  4. Patient undergoes pre-operative testing and evaluations to ensure they are a suitable candidate for surgery.
  5. Patient receives instructions on pre-operative preparations, such as fasting and medication adjustments.
  • After bladder surgery:
  1. Patient undergoes the bladder neck needle suspension surgery.
  2. Patient is monitored closely in the recovery room for any immediate post-operative complications.
  3. Patient may experience pain, discomfort, and urinary catheterization in the immediate post-operative period.
  4. Patient is discharged from the hospital after a few days and instructed on post-operative care, such as wound care and activity restrictions.
  5. Patient follows up with their healthcare provider for post-operative appointments to monitor healing and address any concerns.
  6. Patient experiences improvement in urinary incontinence symptoms over time as the surgical site heals and the bladder function stabilizes.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with bladder neck needle suspension surgery?
  2. What is the success rate of bladder neck needle suspension surgery compared to other surgical options for urinary incontinence?
  3. How long is the recovery period after bladder neck needle suspension surgery?
  4. Are there any alternative treatment options for urinary incontinence that may be more effective?
  5. What is the cost of bladder neck needle suspension surgery compared to other treatment options?
  6. How experienced are you in performing bladder neck needle suspension surgery?
  7. Will I need to follow any specific post-operative care instructions after the surgery?
  8. What can I expect in terms of improvement in my symptoms after bladder neck needle suspension surgery?
  9. Are there any lifestyle changes or exercises that may help improve the success of the surgery?
  10. How long do the results of bladder neck needle suspension surgery typically last?

Reference

Authors: Glazener CM, Cooper K, Mashayekhi A. Journal: Cochrane Database Syst Rev. 2017 Jul 25;7(7):CD003636. doi: 10.1002/14651858.CD003636.pub4. PMID: 28742262