According to the experts at the American Congress of Obstetricians and Gynecologists, surgery can improve stress urinary incontinence symptoms in most women. There are different procedures and different ways to perform them, such as through an incision in the abdomen or the vagina or with a laparoscope, a tool that requires much smaller incisions. Some of the factors that might influence the choice of procedure are your age, lifestyle, medical history and the reason for your incontinence.
When the urethra has dropped from its natural place or if its sphincter muscle is weak, placing and attaching a sling (think of it as a narrow strap) under the urethra acts as a hammock to lift or support it and the neck of the bladder. Traditionally the sling is a strip of tissue (even your own) or synthetic material. There are different ways to attach the sling internally; some procedures take under 30 minutes to complete and don’t require an overnight hospital stay.
When the bladder or urethra has dropped out of place, a procedure called a colposuspension may be done to return the bladder neck to the correct position using supportive stitches.
Recovery time is shorter for laparoscopic or vaginal surgery, longer for abdominal surgery. You may experience a few days or a few weeks of discomfort, and at first you may find it hard to urinate and possibly need to use a catheter to empty your bladder. During recovery, you’ll probably be told to avoid putting stress on the area, including strenuous exercise and heavy lifting. In rare cases, the stitches or the sling may need an adjustment, and there is the chance that your body may reject a synthetic sling.
All surgery has some risk, and each procedure carries specific risks such as bleeding or injury to the bladder, bowel or blood vessels. There is the possibility of developing a urinary tract infection (more so with the sling than a colposuspension) or another urinary problem.
If you’ve tried non-surgical methods like exercise or incontinence products for women, you may want to explore the possibility of surgery with your doctor. For many women who have surgery, the success rate is good.