Surgical treatment for female stress urine incontinence

When alternative therapies fail, surgery may provide a permanent cure for women with stress urine incontinence. Learn about your surgical alternatives.

Stress urinary incontinence is the loss of bladder control brought on by coughing, sneezing, laughing, exercising, or heavy lifting.

Stress incontinence is often treatable with a variety of conservative therapies. These include lifestyle modifications, workouts, weight reduction, and vaginally placed bladder support devices. When these methods fail, women with bothersome stress incontinence may consider surgery.

Despite the increased risk of problems associated with surgery compared to other treatments, it may provide a long-term cure. The optimal surgical therapy for stress incontinence will rely on the advantages and disadvantages of each technique, as well as your specific health and treatment requirements. Incontinence Treatment – Emsella – From Lipo Freeze 2 U Sheffield

Treatment purpose

When a person has stress incontinence, pressure on the bladder affects the urethra and bladder neck. The urethra is the tube via which urine is expelled from the bladder. The neck of the bladder is where the urethra connects to the bladder. The external urethral sphincter is a set of muscles that controls the discharge of urine by shutting the urethra.

Surgical therapy aims to stabilise the urethra and bladder neck. This additional support keeps the urethra tight when pressure is applied, preventing urine leakage.

Possible dangers

As with any surgical procedure, urinary incontinence surgery carries hazards. Despite their uncommon, potential issues include:

  • Temporary urinary incontinence
  • Temporary bladder emptying difficulties (urinary retention)
  • The emergence of a hyperactive bladder
  • Urinary tract disease
  • Wound contamination
  • Difficult or painful sex
  • Surgical instrument protruding into the vagina
  • Groin ache

Discuss the risks and advantages associated with your surgery choices with your healthcare provider and surgeon.

Additional factors to consider

Before opting to have surgery, consider the following:

  • Get an accurate diagnosis. Different forms of incontinence necessitate distinct treatments. For additional diagnostic testing, your healthcare practitioner may send you to an incontinence expert (urogynecologist or urologist).
  • Recognize that surgery corrects just the condition it was planned to solve. Stress incontinence surgery does not address the sudden, intense desire to urinate (overactive bladder). Mixed incontinence, which is a mixture of stress incontinence and overactive bladder, would likely need further therapies.

Consider your intentions for starting a family. Your doctor may advise you to delay surgery until you are done having children. The impact of pregnancy and childbirth on your bladder, urethra, and supporting tissues might negate the benefits of surgery.


Most commonly, a sling is used to support the urethra or bladder neck. Typically, the sling is fashioned from a synthetic material or a strip of the patient’s own body tissue.

Your surgeon will describe the advantages and disadvantages of various surgical materials and methods for sling installation. Although it is uncommon, synthetic mesh can degrade.

Recovery periods vary depending on the surgery. Your surgeon may prescribe two to six weeks of recuperation before you resume normal activities. You will also receive guidelines on when you can resume physical activity and sexual engagement.

No-stretch slings

A tension-free sling is often a mesh manufactured from the synthetic substance polypropylene. The sling serves as a hammock to support the urethra and is maintained in place by bodily tissues rather than sutures. Scar tissue grows within and around the mesh throughout the healing phase to prevent its movement.

Your surgeon will likely prescribe one of these techniques for a sling operation without tension:

  • Retropubic surgery. To gain access to the urethra, the surgeon creates a tiny incision inside of the vagina. There are also two minor incisions immediately to the right and left of the centre, just above the pubic bone. The surgeon passes each end of the sling from the vagina to the abdomen using a needle. Along the course of the sling, soft tissue holds it in place. The vaginal incision is closed with absorbable stitches, whereas cutaneous wounds may be sealed with glue or stitches.
  • Transobturator surgery. A tiny incision is made in the vagina, as well as in the right and left groyne. The surgical procedure is comparable to the retropubic method, with the exception that the mesh is inserted via the groyne muscles instead of the abdominal wall.

Both sling techniques are successful and safe. However, the transobturator sling may not be as effective if you simultaneously require additional treatments to address pelvic floor issues.

The single-incision mini-procedure is another tension-free sling. The surgeon makes one little incision in the vagina. A tiny mesh hammock is hanging from the pelvic region’s tissues. The surgeon avoids the groyne muscles with caution. Mini procedures with a single incision are typically less successful. This approach requires more study to determine its safety and efficacy.

Traditional slings

A typical sling supports the bladder neck with tissue from the patient’s own body. The surgeon obtains tissue for the sling either from the belly or the thigh. The surgeon next creates an incision in the vagina to position the sling beneath the urethra at the neck of the bladder. The surgeon sutures either end of the sling to the abdominal wall via an abdominal incision.

A tension-free sling often requires a smaller incision than a standard sling. You may require an overnight hospital stay and a prolonged healing period. You may also require a temporary catheter while you recover from surgery.

This operation is connected with an increased risk of urinary retention. Therefore, it is often reserved for women who have undergone another surgery for incontinence but continue to have urine incontinence.

Suspension of operations

Suspension treatments give support for the urethra or bladder neck by elevating the tissues around the urethra toward the pelvic structures.

The most used approach is the Burch method. The surgeon ties one end of surgical threads to the vagina’s outer wall and the other end to ligaments around the pelvic bone’s apex. In essence, these sutures (dissolvable stitches) suspend the vaginal to the vaginal tendon. When the stitches are stretched, the vagina is repositioned to support the neck of the bladder from below.

Suspension operations are conducted by a lower abdominal incision or numerous tiny incisions (laparoscopic surgery). During a laparoscopic operation, the surgeon employs a video camera and small, tube-attached devices. However, laparoscopic surgery may not be as effective as open surgery.

One manoeuvre at a time

Finding a successful treatment for stress urine incontinence may need time and several stages. If a conservative therapy is ineffective for you, ask your doctor if surgery may be a possibility.

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