Surgery for Urinary Incontinence?

Urinary incontinence is a common condition affecting 30-50 percent of women. The number of women affected by urinary incontinence increases with age but it should not be considered acceptable at any age. It is important to correctly diagnose the type of incontinence a patient suffers from, because treatment can differ based on the type of incontinence.

Urinary incontinence is typically one of two types: stress incontinence or urge incontinence. Stress incontinence occurs when there is leakage of urine with increased abdominal pressure such as when one coughs, sneezes or laughs. Urge incontinence (also known as overactive bladder) is defined as the inability to hold urine long enough to reach the bathroom when the urge to urinate is felt.

Surgical treatment may not be required for every patient with incontinence. Most patients with urge incontinence will respond to behavioral and medical therapy. Stress incontinence can also initially be treated with non-surgical treatment. The symptoms of stress incontinence can be reduced by strengthening the muscles in the pelvis. Physicians can help patients strengthen their pelvic floor muscles with office-based therapy such as biofeedback.

The time to consider surgery for urinary incontinence is when:

• Symptoms of incontinence are not acceptable to the patient.
• The correct diagnosis for the type of incontinence has been made.
• The patient has been counseled on the non-surgical options for treatment for her type of incontinence.
• The patient has been counseled on the surgical options for treatment of her type of incontinence.

Urinary incontinence is typically treated with outpatient surgery. Treatment of stress incontinence can be in the form of a sub-urethral sling or urethral bulking injection. Urge incontinence that is unresponsive to medication can be treated with neuromodulation, a procedure where a bladder pacemaker is placed to reduce bladder urgency. Consulting with a physician who treats urinary incontinence on a regular basis will likely lead you to the best treatment.