Dr. Nguyen Thi Hong Oanh, a specialist in obstetrics and gynecology II at the Female Urology Unit, Urology - Nephrology - Andrology Center, Tam Anh General Hospital Ho Chi Minh City (TP HCM), noted that Ms. Tam suffered from stress urinary incontinence. A significant contributing factor was her history of giving birth four times. Each pregnancy and delivery stretches, and sometimes damages or tears, the pelvic floor muscles and ligaments that support the uterus and bladder, especially during labor.

The condition, which persisted for 10 years, led to the degeneration of Ms. Tam's pelvic muscles and ligaments. Her bladder and urinary tract underwent changes, and her urethra showed increased mobility when abdominal pressure rose. As she is also in menopause, Ms. Tam experienced reduced estrogen levels, causing the urethral lining and pelvic floor muscles to thin and weaken, thereby decreasing the urethra's ability to close tightly.

Dr. Oanh recommended a transobturator tape (TOT) sling procedure. The surgeon made a small incision and threaded an artificial mesh tape to support the urethra, adjusting the tension to treat incontinence without causing urinary retention. The incision was closed with dissolvable sutures. The TOT tape acts as an artificial support. When pressure arises from coughing or heavy lifting, the urethra is compressed against the tape and closes, preventing urine leakage.

Dr. Oanh (seated) performs a TOT sling procedure for a patient. Photo: Tam Anh General Hospital

Ms. Tam was discharged one day after surgery, with her urinary incontinence resolved, and she could walk gently. Patients need to avoid lifting heavy objects for at least four to six weeks to prevent the tape from shifting. They should also eat plenty of green vegetables, drink enough water, and maintain intimate hygiene as advised by their doctor.

Urinary incontinence is a common condition among middle-aged women. Frequent pregnancies and childbirth, along with menopause, are common causes. Other risk factors include overweight and obesity, constipation, high caffeine intake, alcohol, tobacco, or spicy foods that irritate the bladder.

According to Dr. Oanh, mild cases can be managed or treated with Kegel exercises and bladder training, which involves scheduled urination and gradually increasing the time between voids to enhance bladder capacity. Patients should also adopt lifestyle changes such as weight loss, limiting caffeine and alcohol, and consuming more fiber to prevent constipation. When the condition progresses, doctors may prescribe medication, insert a vaginal pessary, or recommend surgery. Patients should consult a urology specialist for appropriate treatment advice.

Dinh Lam

*Patient's name has been changed