Stress incontinence surgery is a surgical procedure performed to address stress incontinence, which is leakage of urine that occurs when the bladder and urethra are under stress. In people with stress incontinence, coughing, exercising, and engaging in other physical activities can be accompanied with incontinence. Women are more likely than men to experience this form of incontinence and there are some noninvasive treatments that may be considered before turning to surgery. If surgery is necessary, it is performed by a urologist, a surgeon who specializes in the urogenital system.
In stress incontinence, the normally tight seal in the urethra becomes unreliable. This may be because the bladder moves out of position and puts pressure on the urethra, or because the muscles weaken. Some people have congenital stress incontinence, while others acquire it later in life as a result of trauma, multiple childbirths, and other life events. A urologist can evaluate a patient to confirm that the cause is stress incontinence and provide patients with access to treatment options including bladder training and exercises that may help strengthen the urethra.
There are several choices for stress incontinence surgery including a transobturator tape (TOT) procedure, trans-vaginal tape (TVT) procedure, Burch procedure, and urethral suspension. These surgeries can involve moving the bladder back into position and stabilizing it so that it will not pressure the urethra. Another option is to stabilize and support the urethral head to help it keep a tight seal until someone is ready to urinate. Many patients experience success with these surgeries. A surgeon can consult with a patient to discuss the best option, based on the surgeon's experience and the patient's case.
Depending on the procedure, local, regional, or general anesthesia may be used. When the stress incontinence surgery is over the patient commonly needs to wear a catheter for several days while the bladder and urethra recover. It is normal for the urine to be bloody at first. Periodic exams will be used to determine when the catheter can be removed to allow the patient to urinate independently.
Risks of stress incontinence surgery can include damage to the bladder or urethra, infections, or surgical failure. Using a skilled urologist with extensive experience can reduce the risks and it is important to follow the surgeon's directions for care before and after surgery. Patients who notice signs of complications or problems after stress incontinence surgery should report them as quickly as possible so that can receive prompt medical attention.