Patient Story: Stress Incontinence from Front Ligament Looseness

Mrs CYL, was 55 years old and she had had 3 normal deliveries. She had chronic bronchitis, and she gave this story. 

“I was at a cocktail party with my husband. It was a special occasion and I was wearing my new long gown. I started coughing. It was terribly embarrassing. The urine just ran down my leg and it wouldn’t stop. I left a trail of urine on the carpet. I wanted the earth to open and swallow me.

Previously, I hadn’t wanted to go to the doctor, because my sister had a big operation for the same thing. She had all sorts of problems after the operation. She couldn’t pass urine for a month and she had to learn to self-catheterize. Even now she has to lean forward to pass urine and wait, and go again. She still has incontinence. 

I had managed to cope in the past by going very frequently to the toilet to empty my bladder. After the cocktail party episode, my husband suggested I at least go and talk to my doctor. I told the doctor about my sister. He said there was a new technique which didn’t cause much pain or problems with passing water, and he said he would refer me to a clinic which specialized in this method”.

Mrs CYL had our standard assessment, which confirmed that the damage was in the front ligament. We were amazed to find that she was leaking almost one third of her normal urine output into large incontinence pads. The ultrasound showed that her bladder and urethra became one large funnel when she coughed and the urine just ran out.

We explained to her that stress incontinence denotes looseness in the front ligament. The operation was simple. A small length of polypropylene tape was inserted through a very small incision in the vagina and placed in the exact position of the front ligament. The patient went home the next day entirely dry.