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Published on June 26, 2017

Urinary incontinence: Finding the right surgical solution

From holding back a hearty laugh to avoiding favorite activities, some women limit how they live their lives because they fear they might leak urine.

Noah MayBut women need to know this: “Urinary incontinence can be treated,” says Noah May, DO, a urologist at Mercy Fitzgerald and Mercy Philadelphia Hospitals. “You just need to ask for help.”

Simple solutions—like changing bathroom habits or learning Kegel exercises to strengthen pelvic floor muscles—can often make a difference. But if those don’t work, then surgery may be the next step, Dr. May says.

When is surgery needed?

The right surgical treatment depends on the type of bladder-control problem.

Stress incontinence. This type of urinary incontinence is triggered by things that put pressure on the bladder, like coughing, laughing or sneezing. Surgery may be recommended if a woman has moderate to severe leakage despite trying treatments such as Kegel exercises or if she uses multiple pads a day just to keep dry.

A sling procedure is the gold standard for surgery, Dr. May says. A doctor uses a natural or synthetic material to create a supportive hammock for the urethra (urine tube). This reduces or prevents leakage.

Urge incontinence (overactive bladder). Women with this condition may leak urine when they have strong urges to go. One surgical option is an implanted sacral neuromodulator stimulator—a sort of pacemaker for the bladder. The device uses electrical nerve stimulation to help calm the bladder muscles.

“It’s very useful for severe urge incontinence that doesn’t respond to medicines,” Dr. May says.

Speak up

Don’t feel embarrassed to talk about urinary incontinence—it’s very common. “And we have good solutions for it,” Dr. May says.

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