Surgeries for female stress incontinence

Surgeries for female stress incontinence help control involuntary leakage of urine by supporting the structure of the urethra and bladder.

Urethral suspension; Marshall-Marchetti-Krantz operation; MMK; Pubo-vaginal sling; Burch procedure; Trans-vaginal tape procedure; TVT procedure; Vesicourethral suspension 

Open bladder and urethral surgeries are usually performed to prevent urine leakage associated with stress incontinence. Stress incontinence is an involuntary leakage of urine that occurs when laughing, coughing, sneezing, or lifting. The condition can be caused by deformity or damage to the urethra, bladder, or pelvic muscles. Multiple births and menopause can cause a loss of muscle tone in the bladder area. 

The bladder may sag into or outside the vagina. You may feel this during sexual intercourse, or may even see the bladder protruding outside of the vagina.

Surgery is done to try and return the bladder and urethra to its normal position. There are two common ways of performing stress incontinence surgery: through the abdominal wall or though the vagina. Surgery may either require general anesthesia, local anesthesia, or regional (spinal) anesthesia.

You may return from surgery with a Foley catheter or a suprapubic catheter in place. The urine may initially appear bloody, but this should gradually go away. How long the Foley or suprapubic catheter stays in place depends on your ability to completely empty your bladder. It may be removed several days after surgery or, in rare cases, it may stay in place for a longer period of time.

Another treatment option uses a cystoscope (tube to view the bladder area) to inject a bulking agent such as collagen into the urethra. Such injections help make the opening of the urethra smaller, which prevents urine loss.

Repair of the bladder and urethra may be recommended for treatment of stress incontinence (inability to prevent urine leakage when coughing, sneezing, laughing, jumping, walking, sitting, or standing).