Learning About Surgeries for Stress Incontinence in Women

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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 do something that puts pressure on your bladder and urethra (the tube that carries urine out of the body). It can happen when you sneeze, cough, laugh, or exercise. 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 weaken the pelvic floor muscles. The pelvic floor muscles support the urethra. When these muscles are weak, the urethra drops down when there is abdominal pressure from laughing, coughing, or another reason. This allows urine to leak out.

How is surgery used for treatment?

There are different kinds of surgeries to help with stress incontinence. They are done to support or lift the urethra or the bladder. This makes it less likely for you to leak urine when you sneeze, cough, laugh, or exercise.

Types of surgeries include:

  • Urethral sling. A sling is placed under the urethra. The sling helps support the urethra. The sling can be placed through small cuts in your belly or upper thigh. Or it may be done through one larger cut in your lower belly.
  • 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 sagging bladder and urethra are attached 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 small cuts in your belly. Or it may be done through one larger cut in your lower belly.

Surgery can be very effective, but it has risks. When deciding whether to have surgery, talk about the risks and benefits with your doctor.

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 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?

Go to http://www.healthwise.net/patientEd

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The Health Encyclopedia contains general health information. Not all treatments or services described are covered benefits for Kaiser Permanente members or offered as services by Kaiser Permanente. For a list of covered benefits, please refer to your Evidence of Coverage or Summary Plan Description. For recommended treatments, please consult with your health care provider.