What is urinary incontinence surgery?

Surgery is usually considered when other kinds of treatments aren't helping enough. The surgery options will depend on what is causing the incontinence. Surgery won't always cure the symptoms. But it will usually improve them.

Surgery choices

For incontinence caused by an enlarged prostate (benign prostatic hyperplasia, or BPH), options include:

• Minimally invasive procedures, such as prostatic urethral lift and water vapor thermal therapy.
• Transurethral resection of the prostate (TURP).
• Simple prostatectomy.

Severe incontinence caused by removal of the prostate (radical prostatectomy) may be treated with surgery if the incontinence doesn't go away after a period of watchful waiting. These procedures include:

• Urethral bulking. Material is injected around the urethra, the tube that carries urine from your bladder to the outside of your body. This procedure makes it less likely that urine will leak out.
• Perineal sling. A sling is placed beneath the urethra to lift and compress the urethra. This gives the urethra greater resistance to pressure from the belly.
• Artificial urinary sphincter. A silicone cuff is fitted around the urethra. The device also includes a balloon reservoir and a pump. You can inflate or deflate the device to control urination.

For incontinence not helped by other treatments, options may include:

• Sacral nerve stimulation (SNS). An electrical stimulator is placed under your skin. It sends pulses to the sacral nerve in your lower back. This nerve plays a role in bladder storage and emptying.
• Surgery to make the bladder bigger (augmentation cystoplasty).
• Surgery to make another way to store and pass urine (urinary diversion).

Recovery can take 4 to 6 weeks. You will need help around the house during this time. You will not be able to do any heavy lifting or strenuous activities for at least 6 weeks. You may need to take off work for several weeks. It depends on which type of surgery you have. You may feel more tired than usual. This can last for up to several weeks.

After surgery you should have less or no urine leakage when you sneeze, cough, laugh, or exercise. At first you may find that it is harder than usual to empty your bladder. This usually improves within several weeks.