Patient education: Surgery to treat stress urinary incontinence in females (The Basics)

What is stress urinary incontinence? — People with this condition leak urine when they laugh, cough, sneeze, or do anything that puts pressure on the belly. Surgery is 1 treatment for females with stress urinary incontinence.

There are other treatments besides surgery. But if these treatments do not work well, or you don't want to try them, you might have surgery.

How is surgery to treat stress urinary incontinence done? — Most surgery to treat stress urinary incontinence in females is "minimally invasive" surgery. This means the doctor makes smaller cuts than in regular surgery, using small tools that they control from the outside. With minimally invasive surgery, you can go home on the same day. But doctors can also do "open" surgery. This means they make a cut big enough to work on the body directly.

Are there different types of surgery to treat stress urinary incontinence? — Yes. There are many types. They include:

●A "sling procedure" – A sling is a small piece of material that goes around the urethra. (The urethra is the tube that carries urine out of the body.) There are different types of slings, but they all give the urethra support to help keep it from leaking urine (figure 1). The sling can be made of artificial mesh or tissue from your own body.

●A procedure called the "Burch procedure" – This is also called "retropubic colposuspension." For this procedure, a doctor attaches the tissue around the urethra to strong bands of tissue inside the pelvis. This can be done with "minimally invasive" surgery (several small cuts) or "open" surgery (1 large cut).

●A shot of material next to the urethra – The material makes the area around the urethra thicker. This helps support the urethra and keep urine from leaking out. This treatment is mostly for people who still have stress incontinence after they have already had surgery. It might also be an option for people who do not want the risks of regular surgery. It is usually done in a doctor's office.

What are the benefits of surgery? — The main benefit is that surgery can often fix stress incontinence when other treatments do not.

What are the risks of surgery? — The risks of surgery are different depending on:

●What type of surgery you have

●Your age and overall health

The risks of surgery include:

●Problems from surgery, such as bleeding, infection, or a tear in the bladder

●Trouble getting all the urine out when urinating

●Stress incontinence after surgery – Some people might still have stress incontinence after surgery.

●Urgency incontinence – This is also called "urge incontinence" or "overactive bladder syndrome." This might be a feeling of having to urinate all the time or needing to urinate immediately. Some people also leak urine if they don't get to the bathroom in time. This can happen after surgery, or can get worse for people who had it before surgery.

●Pain during sex

●Pain in the groin – This is the area where the thigh meets the rest of the body.

Are there options besides surgery for stress urinary incontinence? — Yes. There are other options. These include exercises or a pessary. (A pessary is a device that you wear in the vagina every day to support the urethra.) Most people try these other options first. Then, they have surgery if other treatments do not work.

It's important to remember that the results of surgery are different for everyone. You are the only one who can decide for sure whether surgery is the best treatment for you. If you aren't sure, you might want to try other treatments while you think about surgery. Talk with your doctor about how much surgery might help you.

What if I want to get pregnant? — Doctors don't usually do surgery to treat stress urinary incontinence in people who want to get pregnant in the future. That's because pregnancy puts stress on the belly and urinary tract. This can make stress incontinence come back, even after surgery.

More on this topic

Patient education: Urinary incontinence in females (The Basics)
Patient education: Minimally invasive surgery (The Basics)
Patient education: Pelvic floor muscle exercises (The Basics)
Patient education: Questions to ask if you are having surgery or a procedure (The Basics)
Patient education: Bladder spasm (The Basics)

Patient education: Urinary incontinence in women (Beyond the Basics)
Patient education: Urinary incontinence treatments for women (Beyond the Basics)