LOSS OF BLADDER CONTROL IS TREATABLE TAKE CONTROL AND RESTORE YOUR LIFESTYLE
TALKING ABOUT STRESS INCONTINENCE (SUI) Millions of women suffer from stress incontinence (SUI). This condition results in accidental loss of urine upon coughing, laughing, sneezing, or simply getting up from a chair. SUI is frustrating and embarrassing, causing some people to severely limit their activities and lifestyles. Many treatment options for SUI are available. Monarc sling system is a simple procedure that corrects the conditions that cause SUI and can free you from the limitations associated with SUI.
HOW DO I KNOW IF I HAVE INCONTINENCE? Ask yourself the following questions: Do you leak urine unexpectedly? Is the urine leakage: - Mild (a few drops) - Moderate (wet underwear) - Severe (wet outwear) Does the urine loss occur during coughing, sneezing, laughing, bending or lifting? Does the urine loss occur when you change from a sitting or lying position to a standing position? Do you leak urine continuously? Has this urine loss caused you to change your lifestyle? If you answered Yes to any of these questions, take the next step and talk with a doctor or other healthcare professional. 1
CAUSES OF STRESS URINARY INCONTINENCE (SUI) Urinary incontinence in women can be caused by any single condition or a combination of conditions. To effectively diagnose and treat urinary incontinence, a doctor must determine the cause. Pregnancy and Vaginal Childbirth: Weakened or damaged pelvic muscles and tissue can be the result of pregnancy and childbirth, causing the bladder and urethra to relax from their normal positions. The bladder and urethra must be well supported by the pelvic muscles and tissue to allow them to work properly. Aging and Genetic Factors: Aging tends to worsen all forms of muscular injury. Changes in pelvic muscles can contribute to urinary incontinence. Medical Conditions: Certain medical and neurological conditions, such as hysterectomies, spinal cord problems (e.g., spina bifida, spinal cord injury, malformation of the lower spine), multiple sclerosis, Parkinson s disease, stroke and diabetes can make incontinence worse. 2
Infections and medications: Urinary tract infections can cause temporary incontinence, and certain medications may increase the likelihood of temporary incontinence. Obesity: While obesity does not cause incontinence, it does contribute to the condition due to the increased abdominal pressure. Smoking: While not a direct cause of incontinence, smoking may aggravate urinary incontinence. 3
HOW MONARC WORKS In women with stress urinary incontinence, pelvic muscles and tissue have been weakened by pregnancy, childbirth, trauma, radiation, prior surgery, muscle damage or hormonal changes, causing the bladder and urethra to relax from their normal positions. The sudden, added pressure from coughing, sneezing, laughing or simple lifting can cause accidental loss of urine. The Monarc sling system helps to correct the conditions that cause stress urinary incontinence with a mesh sling that supports the urethra. A narrow strip of polypropylene mesh is surgically placed in your body to cradle your urethra and give it a point of support. The self-fixating mesh anchors itself to tissue and muscle in the space surrounding the urethra. YOUR BODY BEFORE INCONTINENCE BLADDER SPHINCTER AND SUPPORTING TISSUE When urethra is well supported it prevents urine leakage 4
YOUR BODY WITH INCONTINENCE When pelvic floor muscles are weak, the urethra is no longer supported, allowing urine to escape YOUR BODY AFTER A MONARC SLING REPAIR SLING Placement of Monarc sling supports the urethra and prevents urine leakage Be sure to discuss all treatment options with your physician. 5
MONARC S PLACEMENT INTO YOUR BODY Placement of the sling system is usually performed during an outpatient procedure in less than an hour under local, regional, or general anesthesia, depending on what you and your doctor choose. Narrow mesh carriers are passed through an area near the groin at the obturator of the pubic bone. The mesh is then attached and pulled into place under the urethra. 6
VIEW OF MONARC IN PLACE 7
WHAT TO EXPECT AFTER MONARC PLACEMENT Your doctor may insert a catheter through your urethra to drain urine from your bladder. The catheter is usually removed before you leave. If your bladder does not empty properly, you may have to wear your catheter for an extra day or two. In some cases, you may have to use a catheter at home until normal voiding resumes. In addition, your doctor may prescribe antibiotics to prevent infection. Most women see results as soon as the catheter is removed, usually within a day or two after the procedure. Although many women have little or no pain after the procedure, your doctor may prescribe an analgesic for you. Your incisions will be small and should heal quickly. For approximately four to six weeks, you should avoid sexual intercourse, heavy lifting, and rigorous exercise. Your doctor will provide you with additional information on your care after surgery for stress urinary incontinence, including any other limitations to activities. Be sure to discuss all treatment options with your physician. 8
WARNINGS AND PRECAUTIONS As with most surgical procedures, potential adverse reactions may occur. Some potential adverse reactions to surgical procedures to correct urinary incontinence include: Pain/Discomfort/Irritation Infl ammation (redness, heat, pain, or swelling resulting from surgery) Infection Mesh erosion (presence of suture or mesh material within the organs surrounding the vagina) Mesh Extrusion* (presence of suture or mesh material within the vagina) Fistula formation (a hole/passage that develops between organs or anatomic structures that is repaired by surgery) Foreign body (allergic) reaction to mesh implant Adhesion formation (scar tissue) Urinary incontinence (involuntary leaking or urine) Urinary retention/obstruction (involuntary storage of urine/blockage of urine fl ow) Voiding dysfunction (diffi culty with urination or bowel movements) Contracture (mesh shortening due to scar tissue) Wound dehiscence (opening of the incision after surgery) Nerve damage Perforation (or tearing) of vessels, nerves, bladder, ureters, colon, and other pelvic fl oor structures Hematoma (pooling of blood beneath the skin) Dyspareunia (pain during intercourse) *Extrusion of the mesh into the vagina is one of the most common adverse events. Most often, you may be able to be treated in your doctor s offi ce. In some cases, treatment may occur in the operating room. If left untreated, this complication may interfere with sexual intercourse. *Data on fi le at AMS.
SOLUTIONS FOR LIFE American Medical Systems has been active in pelvic health since 1972 when it developed a cure of urinary incontinence. More than 30 years later, we remain a leader in offering cures for female incontinence and other female conditions including prolapse. AMS also offers products that treat incontinence, erectile dysfunction and benign prostatic hyperplasia (BPH) in men. For a complete list of indications, contraindications, warnings and precautions consult your doctor. If you have questions regarding the currency of this information please contact AMS. For more information on Stress Urinary Incontinence, www.solutionsforurinaryincontinence.com American Medical Systems, Inc. World Headquarters 10700 Bren Road West Minnetonka, MN 55343 USA U.S. Toll Free: 800 328 3881 Phone: 952 930 6000 Fax: 952 930 6157 www.americanmedicalsystems.com 2010 American Medical Systems, Inc. All rights reserved. 601120-01 (03/10) Photos are for illustrative purposes only. Subjects are professional models and do not necessarily use or endorse this product.