Whole Woman Center – Specialists in Continence & Pelvic Health

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Surgery for Urinary Incontinence

Stress urinary incontinence is leakage of urine with physical stress, such as coughing, laughing, or sneezing. It is a common problem for women. Sometimes it can be treated successfully without surgery. At other times, surgery may be the best treatment.

A Woman's Urinary Tract
The urinary tract is made up of the following parts:

Two kidneys, which produce urine
Two tubes called ureters that take urine from the kidneys to the bladder
The bladder, where urine is stored
The urethra, which carries urine from the bladder out of the body

Normal urination (also called voiding) occurs when a woman can empty her bladder when she has a natural need to do so.

Urinary Incontinence
Urinary incontinence is uncontrolled leakage of urine. It is more common in women than in men. Mild leakage affects most women at some time in their lives. Severe leakage is less common.

Stress incontinence occurs when the pressure in the bladder is higher than the pressure in the urethra. This happens when the support tissues and surrounding muscles have weakened and cannot keep the urethra closed, so urine leaks out.

Stress urinary incontinence can happen at any age. It is the most common type of urinary incontinence in younger women, but also often occurs in older women.

No matter what age you are or when the leaks occur, tell your doctor if you have a problem controlling urine leaks.

Treatment
Options for treating stress incontinence include lifestyle changes, physical therapy, devices placed in the vagina or urethra, medications, and surgery.

Types of Surgery
Surgery can be done through a cut in the abdomen (abdominal), through the vagina (vaginal), or with laparoscopy (laparoscopic). The type of surgery depends on many factors. You and your doctor will discuss them before choosing which type of surgery is right for you.

Retropubic Suspension
This treatment is used when the bladder or urethra has dropped out of place.

Suburethral Sling
A sling may be used when the urethra has dropped out of place or when the sphincter muscle of the urethra is weak.

Bulking Injections
Bulking injections may be used when the sphincter muscle of the urethra is very weak and extensive surgery is not an option or has not worked

Risks of Surgery
All surgery has some risk. There may be problems related to the anesthesia used. Infection or damage to the pelvic organs, urethra, bladder, bowel, blood vessels, or surrounding nerves also may occur. In rare cases, the body also may reject the sling or stitches can get infected or may wear away.

Recovery
The time needed to recover varies. It is longer for abdominal surgery and shorter for laparoscopic or vaginal surgery.

Follow-up
You should schedule and keep follow-up visits so your doctor can check if any problems have occurred after surgery and repair them.

How to Prevent Future Problems
Making some changes in your lifestyle can help avoid bladder problems in the future. Be sure to:

Drink plenty of water
Exercise and eat a balanced diet
Keep the pelvic muscles strong by doing Kegel exercises regularly
Quit smoking

You also should avoid constipation. A full bowel puts pressure on the bladder.

Finally...
Urinary incontinence is a common problem for women. Some women just put up with it, but there are many treatment options available to improve the problem. If other treatments do not work, surgery may be an option.

This excerpt from ACOG's Patient Education Pamphlet is provided for your information. It is not medical advice and should not be relied upon as a substitute for visiting your doctor. If you need medical care, have any questions, or wish to receive the full text of this Patient Education Pamphlet, please contact your obstetrician-gynecologist.

To ensure the information is current and accurate, ACOG titles are reviewed every 18 months.