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Urinary incontinence surgery: When other treatments aren't enough
Sometimes symptoms of stress incontinence or overactive bladder don't respond to conservative treatment. When urinary incontinence markedly disrupts your life, surgery may be an option.
Urinary incontinence surgery is usually a treatment of last resort. Surgery is more invasive and has a higher risk of complications than do other therapies, but it can also provide a long-term solution in severe cases. Most surgical options are used to treat stress incontinence, although low-risk surgical alternatives are now available for severe urge incontinence as well.
Things to consider
Before you choose urinary incontinence surgery, you need an accurate diagnosis. Different types of incontinence require different surgical approaches. Your doctor may refer you to an incontinence specialist, such as a urologist or urogynecologist, for further diagnostic testing.
Surgery generally isn't recommended if you plan on having children. The strain of pregnancy and delivery on your bladder, urethra and supportive tissues may "undo" any prior surgical fix.
In some cases, surgery won't completely cure incontinence. Surgery can only correct the problem it's designed to treat. If you have mixed incontinence, for instance, surgery for stress incontinence won't help with your urge incontinence, and you may need to take medications after surgery to address the urge incontinence. For incontinence caused by nerve and muscle damage, surgery can only compensate for the damage; it cannot repair the damaged nerves and muscles.
Urinary incontinence surgery may itself give rise to different urinary and genital problems, such as:
Difficulty urinating and incomplete emptying of the bladder (urinary retention), although this is usually temporary
Development of an overactive bladder, which could lead to urge incontinence
Pelvic organ prolapse
Urinary tract infection
Difficult or painful intercourse
Talk with your doctor to understand the risks and benefits of the different types of surgery and to help you decide which one may be best in your situation.
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