Treatments for Stress Incontinence in Women
Most women with stress incontinence can be treated successfully and resume a full and active lifestyle. In most cases, your doctor will start with less invasive treatments such as physical therapy and lifestyle and behavioral modifications. Medical devices or surgery may be recommended if these treatments do not adequately help your bladder control symptoms.
First Line Treatments
The goal of physical therapy for treating stress incontinence symptoms is to strengthen the pelvic floor muscles so that you can control urine output during everyday activities. Pelvic floor exercises can help prevent urine leakage by strengthening the pelvic floor and sphincter muscles.
Fluid & Diet Management
Changing the amount and timing of fluid intake during the day, as well as avoiding common dietary irritants such as caffeine and tomato-based foods, may help bladder function.
Losing excess weight and quitting smoking (which leads to chronic cough) can help eliminate some of the pressure on your bladder.
Sometimes, treatments are not 100% effective and women with mild urine leakage may want to use absorbent pads for added protection.
Primary Surgical Treatment Options for SUI
Sometimes, conservative therapies do not offer relief from the symptoms of SUI. Learn more about the surgical treatment options available for women at Arizona Urology Specialists.
Urethral slings are the most common and effective surgical treatment option for SUI. Your doctor will perform a minimally invasive procedure to place a sling, a small piece of synthetic mesh, under the urethra. The sling forms a hammock of support for your urethra, keeping it supported to eliminate accidental urine leakage.
Placement of the urethral sling is done as an outpatient procedure and only requires a small incision in the vagina. You can expect to go home a few hours after the procedure. Most women do not experience major pain or discomfort after the placement.
- A minimally invasive outpatient procedure
- An effective treatment for SUI for more than 30 years
- Many women see immediate results following placement of the sling
- Covered by most major medical insurance
- General risks associated with surgery
- Serious complications are very rare but can include trouble with urination following the procedure, a reaction to the sling material, or return to incontinence
Urethral bulking involves the injection of a special material called a bulking agent around the urethra. Your doctor can perform this minimally invasive procedure under local anesthesia in the office or in an outpatient surgical center. The bulking agent helps build up the thickness of the urethral wall to support the bladder and form a tight seal to prevent urine leakage. Using a periurethral or transurethral approach, your doctor will inject the bulking material into the area around the urethra.
- No incisions
- A quick procedure with minimal side effects
- Short recovery time
- May not work for some women
- Not a permanent treatment; may need to be repeated over the course of months to years
Secondary Surgical Treatment Options for SUI
Autologous Pubo-Vaginal Sling
An alternative to the urethral sling, the autologous pubo-vaginal sling is an option for women who do not wish to have the more common mesh sling implanted. This procedure utilizes the patient’s own fascia (connective tissue), taken from the thigh or lower pelvic area, to create the sling. Because your doctor uses your own tissue, there is no reaction to synthetic materials. The procedure, which is a more invasive, intricate surgery than a urethral sling, involves a small vaginal incision as well as two small incisions made above the pubic bone to insert and place the sling. A small incision in either the thigh or lower pelvis is also made to harvest the tissue.
Retropubic Suspension Surgery (Burch Procedure)
In some women, the bladder neck and urethra have dropped into the pelvic area, which causes involuntary urine leakage. Retropubic suspension surgery is a less common procedure that treats SUI by lifting the sagging bladder neck and urethra by attaching the bladder to structures behind the pubic bone to provide added support. This procedure is typically performed laparoscopically or through open surgery under general anesthesia through several small incisions in the abdomen.