More than 20 billion dollars a year is spent in America on incontinence and this doesn’t even include corrective surgery. And, until recently, many of the surgical procedures were ineffective.

The symptoms of female urinary incontinence are often the tip of the iceberg indicating other problems within the female anatomy. Here is some valuable perspective on one of the most common anomalies in women’s health and a remarkable new advancement to safely and easily correct it.

We introduced a significant advancement in 2003: the T.O.T. Sling for Urinary Incontinence.

Today’s safest and most effective cure for incontinence has been the well-publicized “sling” mechanism which is surgically implanted to provide bladder support. Now, this highly effective solution has been improved by the T.O.T. (Trans-Obturator Tension-Free Tape), a safer, long-term cure.

The earlier T.V.T. sling is vaginally implanted to provide a lift-and-secure mechanism to support the bladder. Like the T.V.T., the T.O.T. is also a vaginally inserted bladder support sling. In an outpatient surgical procedure, it takes less than 15 minutes to perform.

The T.O.T. Sling is safer in surgical insertion and for the long-term.

Here are the differences in the two slings that set the T.O.T. sling a notch above in safety and long-term effectiveness: The older T.V.T. sling is attached on one side just behind the pubic bone. This placement presents certain inherent risks in its proximity to vital structures including blood vessels, the bladder and bowel.

The T.O.T. sling is attached underneath the pubic bone. This allows less possibility for complications during the surgical insertion because of greater distance from these structures.

Unlike the T.V.T. sling, manufactured of woven mesh, the central portion of the T.O.T. sling is made from an absorbable material (similar to the material used in dissolvable stitches). After approximately 90 days of healing and the formation of supportive scar tissue, the central portion of the T.O.T. will have dissolved into the body.

The long-term theoretical problem with the T.V.T. sling is the danger of the mesh material becoming too tightly attached and possibly eroding into the urethra. The T.O.T. sling effectively avoids both potential issues.

Incontinence is most often the first or most recognizable symptom a woman will experience. Other conditions of the pelvic floor which may present themselves with the initial symptom of incontinence may include prolapse, the herniation or collapse of the vaginal vault and/or uterus.

The female pelvic tissues are dependent on estrogen for strength and support. As a woman ages and estrogen depletes, the trauma produced during childbirth in the earlier years along with the results of aging, weight gain, lifting or straining and constipation can result in the loss of structural integrity within the female pelvis.

Urinary incontinence very rarely exists alone. Most defects are clear on vaginal examination.

Enhanced in-office diagnostics including ultrasound and urodynamics enable doctors to assess accurately each patient’s overall pelvic floor integrity.

Historically, post-menopausal women have toned down their lifestyles to handle incontinence. Today, women are far more physically active, more sexually active and more pro-active about maintaining her lifestyle and overall good health.

The bottom line is that the overall health of women is dramatically improved by early corrective medical attention in a single minimally-invasive surgery, because the condition often earmarked by incontinence will degenerate if left untreated.

Here are a few common questions and answers:

Q: How common is female urinary incontinence?

A: About 85 percent of all women in the child-bearing years and beyond will experience some degree of incontinence.

Q: Is childbirth a cause of incontinence?

A: Absolutely. In fact, when it comes to the structural integrity of the pelvic floor, childbirth is almost always the initial injury. This may begin to degrade the proper interdependent support required for all aspects of the female anatomy to function as designed.

Q: Does this mean that incontinence is often not the only problem?

A: Yes. The greatest advantage we offer to our patients from the beginning is the correct diagnosis of pelvic floor integrity. Each patient with incontinence is evaluated thoroughly. If necessary we plan for the re-support of the entire pelvic floor in a single surgery.

— Doctor Lyons practices in Atlanta and at the Cowles Clinic in Greensboro (Lake Oconee), GA. Contact Dr. Thomas L. Lyons and the Center for Women’s Care & Reproductive Surgery at cwcrs@mindspring.com or www.thomasllyons.com.