Get the free Trans-Obturator Sub-Urethral Sling - Medfusion - medfusion

Fun Lam, MD Karen R. Called, MD Donna Wiggins, MD Jane Fang, MD Elizabeth Gala if, MD Jason Dims dale, MD Lesley Master, MD Ramona Rule, RNA Carolyn Muir, NP TransObturator Urethral Sling A. Condition:

How to fill out trans-obturator sub-urethral sling

How to fill out trans-obturator sub-urethral sling:

1. Position the patient: Ensure the patient is positioned comfortably, preferably in a lithotomy position with the legs supported and the genital area accessible.
2. Clean and prepare the surgical site: Start by disinfecting the surgical site with an appropriate antiseptic solution. Use sterile drapes to create a sterile field around the area.
3. Administer anesthesia: Depending on the patient's condition and the surgeon's preference, anesthesia may be administered to ensure the patient's comfort throughout the procedure. This could be local anesthesia, regional anesthesia, or general anesthesia.
4. Make an incision: The surgeon will make a small incision in the vaginal wall below the urethra. This incision is typically in the midline and encompasses the area where the sling will be placed.
5. Create the sub-urethral tunnel: The surgeon will then create a tunnel on both sides of the urethra, through which the sling will pass. This is usually done using specialized surgical tools and guided by anatomical landmarks.
6. Insert and position the sling: The trans-obturator sling is then carefully inserted through the tunnels created in step 5. The surgeon will position the sling such that it supports the urethra and helps restore continence.
7. Adjust and secure the sling: The surgeon will test the tension of the sling and make any necessary adjustments to ensure proper positioning and support. Once satisfied, the sling is secured in place using sutures, staples, or other fixation devices.
8. Close the incision: The incision made in the vaginal wall is closed using absorbable sutures or surgical adhesive. This helps facilitate healing and minimize the risk of infection.

Who needs trans-obturator sub-urethral sling:

1. Women with stress urinary incontinence: Trans-obturator sub-urethral sling is primarily recommended for women who experience stress urinary incontinence. This condition is characterized by involuntary urine leakage during activities such as sneezing, coughing, laughing, or exercising.
2. Failed conservative treatments: Patients who have previously tried non-surgical interventions such as pelvic floor exercises, medications, or pessaries, but have not found sufficient relief, may be considered for a trans-obturator sub-urethral sling procedure.
3. Adequate evaluation and diagnosis: Before considering a trans-obturator sling, it is crucial to undergo a thorough evaluation to confirm the diagnosis of stress urinary incontinence. This may involve urodynamic tests, physical examinations, and medical history review.
4. Unwillingness or unsuitability for other surgical options: Some patients may not be suitable candidates for other surgical procedures, such as the retropubic sling or mid-urethral sling. In such cases, a trans-obturator sub-urethral sling might be the chosen alternative.
5. Physician recommendation: The decision to undergo a trans-obturator sub-urethral sling procedure should be made in consultation with a knowledgeable healthcare professional who can evaluate each individual case and provide personalized recommendations.

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