Stress incontinence is the accidental release of urine that occurs when you sneeze, cough, laugh, jog, or do other things that put pressure on your bladder. It's the most common type of incontinence in women.
Stress incontinence can be caused by childbirth, weight gain, or other problems that stretch the pelvic floor muscles. When these muscles can't support your bladder, the bladder drops down and pushes against the vagina. You're not able to tighten the muscles that close off the urethra. Urine may leak because of the extra pressure on your bladder.
Incontinence can have more than one cause, so your doctor will treat the main cause first. Surgery for stress incontinence is usually done only after other treatments have failed.
Other treatments you might try include:
Surgery may be done when stress incontinence is severe and other treatments have not worked. Surgery lifts and supports the connection between the bladder and the urethra.
Surgery works better than any other treatment for stress urinary incontinence in women.1 But sometimes symptoms come back.
Types of surgery include:
Talk with your doctor about things you can do to increase the chance of having a successful surgery. You may have better results if you lose weight or do Kegels before surgery. If you smoke, quit.
Your doctor may suggest surgery if:
|Have surgery for stress incontinence||Don't have surgery|
|What is usually involved?|
|What are the benefits?|
|What are the risks and side effects?|
Are you interested in what others decided to do? Many people have faced this decision. These personal stories may help you decide.
These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.
"I started having stress incontinence after my son was born. After I had my second child, it got worse. I feel like I am way too young to be wearing pads or diapers, and I worry that other people will notice the smell. My doctor showed me how to do some exercises to strengthen the muscles that help hold urine in. I know other women who have been helped by them. I am glad to have options other than surgery."
— Tina, age 39
"I thought I had tried everything for my stress incontinence. I can manage it most of the time, but when I jog, I get quite a bit of dribbling. I went to my doctor to find out whether there was anything I hadn't tried or whether surgery was my only other option. We talked about a lot of options, like pelvic floor exercises and wearing a tampon when I jog to put a little pressure on my urethra and stop the leaking. I am going to give those methods a try."
— Maria, age 45
"Ever since I was in my 20s, I have leaked a little bit of urine when I cough or sneeze or exercise. After I had my kids, it seemed to get worse. I really wanted a solution that would take care of the problem all the time. Even though there are some risks, my doctor and I agreed that surgery was a reasonable choice for me."
— Faith, age 39
"At my last visit, my doctor and I talked about many aspects of getting older: the leaking urine, the weaker bones, the change in my hormones, and all that. I was surprised to learn about surgery to help with my urine leakage problem. It is good to know that so many women have had success from surgery."
— Carrie, age 55
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Reasons to have surgery
Reasons not to have surgery
I've tried Kegel exercises, but they haven't worked for me.
I think that Kegels might work for me.
I don't want to wear absorbent pads or try a pessary to avoid leakage.
I don't mind wearing pads or trying a pessary.
I've tried medicines, but they don't work for me.
I think that medicines might work for me.
Stress incontinence lowers my quality of life.
My quality of life is not too bad.
I think surgery can help me.
I don't want to have surgery for any reason.
My other important reasons:
My other important reasons:
Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.
NOT having surgery
1. Is surgery usually the first treatment for stress incontinence?
2. Can pelvic floor exercises help with stress incontinence?
3. Can symptoms come back after surgery?
1. Do you understand the options available to you?
2. Are you clear about which benefits and side effects matter most to you?
3. Do you have enough support and advice from others to make a choice?
1. How sure do you feel right now about your decision?
2. Check what you need to do before you make this decision.
3. Use the following space to list questions, concerns, and next steps.
|Primary Medical Reviewer||E. Gregory Thompson, MD - Internal Medicine|
|Specialist Medical Reviewer||Avery L. Seifert, MD - Urology|
American Urological Association (2009). Guideline for the surgical management of female stress urinary incontinence: Update (2009). Available online: http://www.auanet.org/content/guidelines-and-quality-care/clinical-guidelines.cfm.