Surgery for stress incontinence

Several procedures have been developed to treat stress incontinence. Most surgical procedures fall into two main categories: sling procedures and bladder neck suspension procedures.

Sling procedures
A sling procedure — the most common surgery to treat stress incontinence — uses strips of your body’s tissue or synthetic material such as mesh to create a pelvic sling or hammock around your bladder neck and the tube (urethra) that carries urine from the bladder. The sling provides support to keep the urethra closed — especially when you cough or sneeze. Slings typically have high rates of effectiveness and low risks of complications

Tension-free slings.

Within the category of tension-free slings there are two approaches: retropubic, also known as suprapubic, and transobturator.

The newer, transobturator approach involves a slight modification to the retropubic approach. Here, the surgeon uses a vaginal incision. The needle enters next to the labia and is threaded under the urethra. Stitches are not needed to hold the sling in place, and the needle site may be sealed with skin glue.

Most sling procedures use synthetic materials. Using natural sling materials taken from animals or deceased donors may be less effective than natural materials from your body or synthetics, because there’s a tendency for the body to absorb animal and deceased donor material.

Sling procedures take less time, they’re less invasive, sometimes they can be done under local anesthesia and on an outpatient basis. Discuss with your doctor which procedure is right for you.

Recovery time for tension-free sling surgery varies. Doctors may recommend two to six weeks of healing before returning to normal activities.