Urinary Incontinence Surgeries

• Urine leakage significantly affects daily life.
• Conservative treatment has not provided adequate improvement.
• The diagnosis of stress urinary incontinence has been established.
• The patient is medically suitable for surgery.
• The expected benefits outweigh the potential risks.

Additional testing may be recommended in patients with complicated, recurrent, or mixed symptoms.

Common Urinary Incontinence Surgeries

1. Midurethral Sling Surgery

A midurethral sling is one of the commonly used surgical treatments for female stress urinary incontinence.

During the procedure, a sling is placed beneath the urethra to provide support when abdominal pressure increases. This can help prevent urine leakage during activities such as coughing, sneezing, or exercising.

Midurethral slings can be placed through different surgical approaches, including retropubic and transobturator routes. The choice depends on individual anatomy, symptoms, previous procedures, and the surgeon's assessment.

The EAU guidelines support offering midurethral sling surgery to appropriate women after discussion of its risks and alternatives.

2. Autologous Fascial Sling

An autologous fascial sling uses the patient's own tissue, commonly fascia from the abdominal wall, to create support beneath the urethra.

This may be considered for selected women, including those who require an alternative to synthetic sling material or have particular clinical circumstances.

Autologous slings are an established surgical option for stress urinary incontinence. However, they may be associated with postoperative voiding difficulties in some patients, so careful counselling is important.