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As we age, one of the many unfortunate side effects that we will have to deal with is urinary incontinence. This means the inability to hold and maintain your urine. In the general population, the most likely form of urinary incontinence is stress incontinence. This is the manifestation of urine after any increased abdominal pressure. This can be from things like deep coughing, sneezing or even laughing. As you could imagine, this is quite a frustrating situation for patients and can also bring about embarrassment. 

The main reason for this type of incontinence is from a general weakening of the muscles that support your bladder wall. There are some exercises that you can try in order to strengthen these muscles but in most cases, they will only provide temporary relief. When the muscle becomes too weak to support the wall of the bladder, the best step for a patient to consider would be ureteral reimplant surgery. 

This is an operation that will have to be done in the hospital but most patients will be able to go home the same day. You will be given general and local anesthesia to help manage the pain that you may be experiencing. A doctor will use a cystoscope in order to pass a camera into your urethra to better visualize the muscles along your bladder wall. The doctor will then insert a needle and implant a bulking agent onto the surface of your sphincter. In a way, it is like glue and will help seal any weaknesses that could lead to urine seeping out of the bladder accidentally. 

There is a small chance that this operation will not be successful and approximately 1 in 3 patients will need to come back to the hospital for a second bulking operation. Some complications that are also extremely rare but possible would be urinary retention. This can occur if the bulking agent is inserted without care into the bladder so the main orifice that allows the flow of urine is blocked. There is also the possibility that the cystoscope was not cleaned properly and an infection is introduced into the bladder. Regardless of what you may think of the current state of medical health in your community, I assure you that hospitals do all necessary preparations to make sure that equipment is clean and sterile before every procedure that those technicians are trained before starting a operation so you can stop stressing over such improbable outcomes. 

Another possible outcome of this surgery could be blood in the urine during the first few days after the operation. This is generally just a sign of trauma that occurred during the operation. The cystoscope likely irritated the side of the ureter when it was inserted or removed during the operation. You should go to your doctor if you notice this problem to make sure that the problem is minor and will self-correct in a few days. There is also a chance that patients could have an allergic reaction to coaptite, the agent used for bulking. 

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