What is urinary incontinence surgery?

Urinary incontinence surgery includes various procedures to treat urinary incontinence, or the involuntary leakage of urine. Incontinence commonly occurs when nerves, muscles and tissues that control urination or support a woman’s pelvic organs are weak or damaged. Childbirth and aging are common risk factors for urinary incontinence. 

Urinary incontinence surgery can relieve or improve urinary incontinence so you can lead a more active, healthy life. However, urinary incontinence surgery entails risks and potential complications. You may have less invasive treatment options. Consider getting a second opinion about all of your treatment choices before having urinary incontinence surgery. 

Types of urinary incontinence surgery

The types of urinary incontinence surgery include:

  • Bladder augmentation surgery treats overactive bladder by increasing the size of the bladder.
  • Bladder neck suspension surgery treats stress incontinence. It involves supporting the bladder and urethra by attaching them to surrounding bone or tissue. 
  • Nerve stimulation procedures treat overactive bladder by applying electrical stimulation to the nerves that control urination. 
  • Sling procedures treat stress incontinence by supporting the bladder neck and urethra with a sling-like device.
  • Vaginal prolapse surgeries help treat stress incontinence and possibly overactive bladder by repairing weak or damaged muscles, ligaments and tissues that hold a woman’s pelvic organs in place. Vaginal prolapse surgeries correct protrusion of the bladder, rectum, bowel, uterus, and vaginal vault (upper portion of the vagina) into the vagina.

Why is urinary incontinence surgery performed? 

Your doctor may recommend surgery for incontinence that has not responded to medication, exercise, bladder retraining, dietary changes, and behavioral therapies. Your doctor may recommend urinary incontinence surgery to treat:

  • Overactive bladder is involuntary contractions of the bladder muscles. This leads to a strong, urgent need to urinate and difficulty getting to the toilet in time.
  • Stress incontinence is involuntary leakage of urine during physical activity, such as coughing, sneezing, or heavy lifting. Stress incontinence results from a sagging bladder and urethra, the tube that carries urine from the bladder to the outside of your body. This often occurs due to weakened muscles that support the bladder and urethra. Stress incontinence is the most common form of urinary incontinence and frequently affects women after childbirth or menopause.

Who performs urinary incontinence surgery?

The following specialists perform urinary incontinence surgery:

  • Urologists specialize in diseases and conditions of the urinary tract and the male reproductive organs.
  • Obstetrician-gynecologists specialize in women’s health and pregnancy.
  • Female pelvic medicine and reconstructive surgeons are urologists or gynecologists who have completed specialized training in women’s pelvic floor disorders.

How is urinary incontinence surgery performed?

Your urinary incontinence surgery will be performed in a hospital or surgery clinic. The types of procedures vary depending on the type of incontinence surgery: 

  • Bladder augmentation surgery for overactive bladder involves an abdominal incision. Your surgeon will open the bladder and expand it using tissue grafts from the small intestine, stomach, or other graft site. This increases the bladder’s capacity to hold urine. 
  • Bladder neck suspension surgery for stress incontinence involves an incision through the vagina or abdomen to reach the bladder. Your surgeon will lift the sagging bladder and urethra back into their normal places and attach them to surrounding bone or tissue. 
  • Nerve stimulation procedures for overactive bladder include invasive and noninvasive options to apply electrical stimulation to the nerves that control urination
  • Sling procedures for stress incontinence involve incisions in the vagina and abdomen to reach the bladder. Your surgeon will loop a natural or synthetic sling under your urethra to provide support and then attach the sling to strong tissues in your lower abdomen.  
  • Vaginal prolapse surgeries for stress incontinence and overactive bladder involve an incision through the vagina or abdomen. Your surgeon will repair the weakened vaginal wall or attach the prolapsed vagina to strong ligaments toward the back of pelvis. Another version lifts the prolapsed vagina by supporting it with mesh, which is attached to the pelvis.