Suppose you’ve been dealing with bladder leaks when you cough, laugh, or sneeze. In that case, you’re probably well aware that you’re dealing with stress urinary incontinence, or SUI. And you’re ready to do something about it.
There are many natural remedies that we’ve discussed previously in this article: Why Do I Get Bladder Leaks When I Cough and What Can I Do About it? But if you’ve already given a good try with the Kegels, lifestyle changes, and pessaries like Uresta, only to find that you’re still struggling to keep your bladder in line, then you may be contemplating surgery to fix the problem.
While surgery isn’t for everyone, it is an option on the table for those with persistent stress urinary incontinence that have tried other treatments without success. There are three major types of surgical interventions used to treat SUI. Let’s find out more about each one to find out which option is right for you.
Before resorting to full-blown bladder surgery, there is an in-between step that is more drastic than natural remedies—but less invasive than surgery. This option involves injecting synthetic bulking material (similar in consistency to natural collagen) into your tissues around the urethra in order to plump and tighten the bladder neck opening and keep urine inside the bladder when you cough or apply pressure.
These injections are done as a minor, outpatient procedure in your local doctor’s office in less than half an hour. Here’s how it’s done:
It’s important to note that these injections are not a permanent solution. It may take multiple injections and must be repeated to maintain the results. These injections usually help decrease leaks, but ultimately, they are not a cure. The success rate is around 80% of women showing an improvement after three injection visits, but only 10-30% are cured of leaks for up to a year.
A more invasive surgical operation for treating stress urinary incontinence urethral sling surgery. Think of a sling as a supportive hammock that lifts your pelvic organs, particularly the bladder and urethra, into position for proper alignment. Sometimes with age, childbirth, and other factors, our bladder organs sink and move from their original positions, resulting in incontinence and other issues like pelvic organ prolapse.
Urethral slings are used to realign your anatomy so that your bladder organs can function properly. The material for the sling can either be made of synthetic mesh (called a mid-urethral sling) or from donor tissue removed from your belly or thigh (traditional or autologous sling).
Surprisingly, mid-urethral sling surgery can be completed as quickly as half an hour and can be done as an outpatient procedure because it has a quick recovery time. However, there are risks to using a synthetic mesh, including mesh erosion which affects 2% of women and leads to long-term problems until removed. It is also not advised for patients who wish to give birth in the future.
While the synthetic mesh is the most common type of SUI sling surgery with a success rate of around 75%, the traditional sling is the solution in the event of a bad reaction with the synthetic version. This surgical procedure is more in-depth and requires a short hospitalization stay during your recovery time. There is a higher risk of UTIs and incontinence after undergoing traditional sling surgery.
Sling procedures can be performed through a variety of methods, from one or more incisions in the abdomen, through the vagina, or even laparoscopically. Your surgeon can guide you through where any incisions will be made for your procedure. Be sure to ask your doctor questions about success rates and risks for the procedure that you’re considering.
See the FDA’s list of specific questions to ask your surgeon before proceeding with a sling surgery, including:
Colposuspension, also called the Burch procedure, is another surgical option for treating SUI in women. This is a procedure where stitches are used to align the bladder neck (where the urethra meets the bladder) back to its proper place and can be done either through an abdominal incision or laparoscopically as an outpatient procedure.
Complications are usually less severe than sling procedures and include the possibility of having to go back in and loosen stitches if you have trouble emptying the bladder after the operation. The success rate of bladder neck suspension for SUI treatment is around 85%.
Living with stress incontinence certainly puts a damper on life. If you’ve tried everything and nothing has worked, surgery may be your next plan of action. If you’re considering bladder surgery for your SUI, talk with your doctor about which surgical option is best for your situation. Your doctor will help you consider factors like your age, future plans for childbearing, medical history, and the root cause of the problem in order to come to the best treatment option.
My Virtual Physician supports patients through counseling and patient education when making big decisions like undergoing bladder surgery. We can also see you virtually from the comfort of your own bed in the event that you’re recovering from surgery and have concerns. Please don’t hesistate to reach out to us today.