Bladder, Bowel and Prostate


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Bladder, Bowel and Prostate

Urinary incontinence surgery is usually performed when all other treatment options have been unsuccessful or are not suitable for the patient. Urinary incontinence takes several forms such as stress incontinence, urge incontinence and overflow incontinence. Each type of incontinence has its own treatment program.

Stress incontinence

The common forms of treatment in women for stress incontinence include the use of tapes, colposuspension, Slings, urethral bulking and artificial sphincters.

In recent times, the use of tapes has been criticised because of product failure. Manufacturers of the tapes have been subject to litigation because some tapes have cut through the vaginal walls causing significant injury. Product liability (the failure of a product used in medicine) is a more specialised area of medical negligence and the number of solicitors undertaking this type of work is limited. Our specialist panel do undertake product liability claims.

The tapes that are used are called TVT (tension-free vaginal tape) or TOT (transobturator tape) and they are used to keep the urethra in the correct position. It is known that these tapes can cause bowel damage.

Colposuspension involves a surgical procedure to lift the neck of the bladder by stitching it into place. Although it is an effective form of treatment, problems which may occur following this treatment include problems in fully emptying the bladder, discomfort during sex and recurrent UTIs (urinary tract infections).

If a sling is the treatment of choice, this will involve making a cut in the abdomen and vagina where a sling is then positioned around the bladder neck for support. Patients with this treatment may go on to suffer from urge incontinence.

In some instances bulking agents are injected into the urethral walls. By bulking the walls of the urethra, closing the bladder uses less muscular force allowing it to remain closed. The disadvantages to this treatment are that further injections may be required and they become less effective after time.

Artificial urinary sphincters are used most often in men, rarely used as treatment for women. This involves the use of a fluid filled collar which surrounds the urethra. A pump is surgically implanted into the scrotum and inflated or deflated as required.

Urge incontinence

Unlike stress incontinence, urge incontinence is where the urge to go to the toilet comes quickly and the flow of urine cannot be held until the person has reached the toilet. Treatment for this type of incontinence includes Botox injections, Sacral nerve stimulation, posterior tibial nerve stimulation, Augmentation cystoplasty and Urinary division.

Botox injections use the Botulinum toxin A and are injected into the bladder walls. The injections relax the bladder but patients taking this form of treatment may not be able to completely empty their bladder. Often catheterisation is also taught to patients undergoing this treatment as a way of helping drain the bladder.

It is important to know that the use of botox in this instance isn’t currently licenced so all known risks must be fully explained before treatment goes ahead.

Sacral nerves are located in the lower back and they carry signals to the muscles surrounding the bladder. Stimulating these nerves is done using an electrical device inserted they help the signals from your brain which reduces the urge.

Rarely a procedure called augmentation cystoplasty is used to treat urge incontinence and it uses tissue taken from your intestine to make the bladder bigger. This course of treatment also requires the mandatory use of a catheter and can cause recurrent UTIs.

When all other treatments are exhausted or unsuitable, urinary diversion may be the only other option. This treatment involves the tubes from your kidneys to be diverted outside of your body into a colostomy bag.

Overflow incontinence

Catheterisation is used to empty the bladder at regular times to reduce overflow incontinence. Catheters are known to cause UTIs.

Transurethral Resection of the Prostate (TURP)

When the prostate becomes enlarged, problems such as starting to urinate, straining urinate, frequency and urge problems as well as being unable to fully empty the bladder can require the TURP treatment to rectify the condition.

This treatment requires a thin metal tube with a light, camera and a loop of wire to be passed up the urethra to the prostate. Using electricity, the wire is then heated so it is able to cut away parts of the prostate which are causing the problems. A catheter is then inserted and fluid is used to flush out the removed tissue.

Bowel

Surgery to the bowel may be required in order to treat a number of conditions such as Chrohn’s disease, ulcerative colitis and bowel cancer. It is not uncommon to experience complications following this surgery and in some cases the complications may be completely unavoidable meaning that negligence cannot be established. In some cases however complications are completely avoidable and are classed as negligent.

Leaks following surgery

The medical term for surgical site leakage is an anastomotic leakage or breakdown. Leakage is quite common and unavoidable, they can cause small abscesses to appear which delay the recovery of bowel function. When leaks are bigger they become more serious and can even lead to fatalities if not diagnosed and treat quickly enough. Diagnosis of a serious leak often happens during the final parts of a surgical procedure or during the period of recovery.

Bowel perforation

Refers to a hole in the wall of the bowel and is a medical emergency requiring surgery and may require a bowel resection. It is thought that even if the correct level of treatment is given there is a 50% survival rate.

Adhesions

Are formed by scar tissue which can cause blockages in the bowel. They can also twist. Adhesions occur after suffering with an infection of the bowel, trauma or surgery.

Hernia

Bowel hernias are also known as inguinal, femoral, umbilical or hiatus. Inguinal and femoral hernias are located in the groin area and are caused by fatty tissue or part of the bowel to poke through into your groin.

Umbilical Hernia

An umbilical hernia occurs when fatty tissue or part of the bowel pushes through around the belly button area. Generally it is a result of repeated straining but it can also occur in babies.

Hiatus Hernia

This is a common condition where at the age of 60, as many as 60% of people will have one. A hiatus hernia is where part of the stomach pushes through an opening in the diaphragm. Many sufferers will not experience any symptoms but the most common is repeated heartburn.

Prostate

The prostate gland is a small walnut sized organ which produces the fluid which is mixed with sperm creating semen.

As men get older the prostate tends to become enlarged. Sometimes though, the prostate gland swells because of a medical condition.

Symptoms of an enlarged prostate include:

  • Difficulty urinating
  • A week flow of urine
  • Frequently waking up during the night wanting to go to the toilet
  • Straining when going to the toilet
  • Needing to urinate more frequently
  • Prolonged dribbling after urinating
Prostatitis

When the prostate gland becomes swollen, sometimes it is caused by a bacterial infection. This condition can affect men of all ages and is usually treat with pain killers or alpha-blockers.

Prostate cancer

The most common form of cancer in men, this condition usually affects the over 65s but men over 50 are also at risk from developing the condition.You can access our cancer pages here.