I Had Surgery for Stress Incontinence and Now I Have Urge Incontinence! What Happened?

Health Professional

There are multiple types of incontinence, and I have discussed them on my SharePost blog previously. What happens when you have been diagnosed with stress incontinence and have undergone surgery and you are still wet? Stress incontinence is traditionally the type of incontinence where one loses bladder control with a cough, sneeze, laugh, or activity.

For the most part, surgical correction is the best way to treat it. I am not going to go into the details of surgeries for stress incontinence. But, I do want to discuss what happens when after surgery you end up with urge incontinence.

Urge incontinence is what is often referred to as overactive bladder (watch a video about overactive bladder). It is where the bladder muscles squeeze without a signal from the brain. It may just cause frequency of urination, but some people have leakage of urine.

So, here you are, having had surgery for your stress incontinence, and now you find that you have increased frequency of urine and even loss of urine unexpectedly, not related to activity like is was before. This is very frustrating, but it has a name - De Novo Urge incontinence. De Novo is Latin for "new." This means that you have acquired a new type of incontinence after getting a different type fixed.

I recently read a journal article that reports about 27% of people (mostly women) have urge incontinence after surgery for stress incontinence. This is a remarkably high number in my opinion, but I do find it is often true. No one knows how to predict who is at risk to have urge incontinence after surgery.

There is good news, however. Post-operative urge incontinence is easily treated with medications. There are at least five different medications on the market for overactive bladder. I truly don't believe that one works better than the other for this situation, and not every medication works well on every person, so it may take some trial and error before you find one that works well for you. Even better news, most people don't need to be on the medications forever either. Sometimes you just need to retrain your bladder for three to six months with the medications.

So why does this happen? There are many theories for this. I think it is because of the bladder's personality. Imagine that your bladder has not had to hold very much urine over the years and was able to leak whenever it felt like it. Now, after surgery, it has to do its job even better and hold more. You probably lost capacity over time, but by taking medications for a few months, you can train the bladder to hold more.

If you find that after surgery, you are having these problems, please go back and see your surgeon. There are some other situations that can cause these symptoms that are more serious, and would need to be evaluated. The important thing to remember is to not get discouraged, and there is an easy solution