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Learning About Surgeries for Stress Incontinence in Women

Location of bladder and urethra in the body, with detail of full bladder causing urine to leak

What is stress incontinence?

Stress urinary incontinence (stress incontinence) is the leaking of urine when you sneeze, cough, laugh, jog, or lift something heavy. These actions put pressure on your bladder and urethra. The urethra is the tube that carries urine from the bladder and out of the body. Stress incontinence is the most common type of urinary incontinence in women.

What causes it?

Stress incontinence can be caused by childbirth, weight gain, or other conditions that stretch the pelvic floor muscles. When these muscles no longer support your bladder or urethra enough, the bladder drops down and pushes against the vagina. This prevents the muscles that close off the urethra from squeezing as they should. This leads to leaking.

How is surgery used for treatment?

There are several different kinds of surgeries to correct stress incontinence. They are done to support, lift, or strengthen the urethra or the bladder. This makes it less likely that urine will leak from the bladder when you sneeze, cough, or laugh.

The kind of surgery you have depends on what you prefer. It also depends on your health, the severity of urine leakage, and your doctor's experience.

Urethral sling

The doctor places a sling around the urethra. The sling helps support the urethra and helps it retain urine. It can be placed through a few small cuts in your belly or upper thigh. Or it may be done through one larger cut in your lower belly. There are different types of urethral sling surgeries. The two main types of slings are midurethral and traditional. Midurethral slings are made out of synthetic mesh material. Traditional slings are made out of a strip of human or animal tissue.

Urethral bulking

Material is injected around the urethra. This is done to build up the thickness of the wall of the urethra so it seals tightly when you hold back urine.

Retropubic suspension

The doctor attaches the sagging bladder and urethra to the pubic bone or to strong ligaments in the pelvis. This returns the bladder and urethra to their normal position. This can be done through a few small cuts in your belly. Or it may be done through one larger cut in your lower belly.

What can you expect after surgery?

Recovery can take 4 to 6 weeks. You will need help around the house during this time. You will not be able to do any heavy lifting or strenuous activities for at least 6 weeks. You may need to take off work for several weeks. It depends on which type of surgery you have. You may feel more tired than usual. This can last for up to several weeks.

After surgery you should have less or no urine leakage when you sneeze, cough, laugh, or exercise. At first you may find that it is harder than usual to empty your bladder. This usually improves within several weeks.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line (811 in most provinces and territories) if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

Where can you learn more?

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