What is Stress Urinary Incontinence (SUI)?

Female Urinary Tract
Female Urinary Tract
Medical Illustration Copyright © 2015 Nucleus Medical Media, All rights reserved

Male Urinary Tract
Male Urinary Tract
Medical Illustration Copyright © 2015 Nucleus Medical Media, All rights reserved

SUI is the most common type of urine leak. It happens when activities like laughing or coughing cause urine to leak. Leakage can be a few drops or enough to soak through your clothes.

Another common bladder problem is called Overactive Bladder (OAB). It is different from SUI. People with OAB often have a sudden urge "gotta go" feeling they can't control. Some people with OAB leak urine when they feel that urge. Visit our OAB page for more information.

Key statistics

SUI is very common in women. About 1 in 3 women have SUI at some time in their life. Over half of women with SUI also have OAB. When they have both it is called "Mixed Incontinence". About one-third of women 60 and younger have some kind of urine leakage. In women age 65 and above, about half have some urine leakage.

SUI is less common in men. Many men with urine leakage have overactive bladder (OAB) instead. For most men who have SUI, it is caused by prostate cancer surgery, injury or nerve damage.

What Happens Normally?

Your bladder is the place where urine is stored until you are ready to release it. Your pelvic floor muscles hold your bladder in place. When you are ready to urinate, the brain signals your bladder muscles to contract (squeeze). This forces the urine out through the urethra.

The urethra is the tube that carries urine out of your body. It has sphincters muscles which help keep the urethra closed. These muscles prevent urine from leaking out.  When your bladder contracts, the sphincters open and urine is released.



What Are the Signs & Symptoms of SUI?

The key symptom of SUI is when urine leaks out during activity. The amount can be a few drops to tablespoons or more. If you have mild SUI, you will leak during forceful activities such as exercise. You may also leak when you sneeze, laugh, cough or lift something. If your SUI is moderate or more severe, you may also leak when you stand up, walk or bend over.

How Can SUI Affect my Life?

You may be embarrassed by your body. You may not feel comfortable talking about this problem with your friends and loved ones. SUI can get in the way of your daily life and social activities. It can affect your relationship with your partner. You may be worried about leaking during sex. It can be embarrassing. Some people even begin to feel isolated and hopeless.

To know if SUI is a problem for you, ask yourself:

  • Is SUI stopping me from doing things outside of my home?
  • Am I afraid to be too far from a bathroom or a change of clothes?
  • Have I stopped exercising or playing sports?
  • Have I changed the way I live because I'm afraid of urine leakage?
  • Have I become uncomfortable with myself and my body?
  • Have my symptoms changed my rleationships with friends or family?
  • Am I avoiding sex because I am worried I may leak urine and be embarrassed?

If you answer yes to some of these, you should know that there is hope. There are many ways to manage and treat SUI.



What Causes SUI?

Front view of bladder.  Weak pelvic muscles allow urine leakage (left).  Strong pelvic muscles keep the urethra closed (right).
Front view of bladder. Weak pelvic muscles allow urine leakage (left).
Strong pelvic muscles keep the urethra closed (right).
National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health

SUI happens when your pelvic floor muscles are stretched, weak or damaged. The pelvic floor muscles support the bladder and uretha. If they become weak, the muscles may not hold in urine. Pregnancy and childbirth can damage or weaken these muscles. SUI be caused by nerve injuries to the lower back or pelvic surgery (like surgery for prostate cancer). SUI can also happen when the sphincter muscles around your urehra are not strong enough to hold back urine

What increases my risk of getting SUI?

SUI is more common among older women. But it is not caused simply by aging or being female. It happens in younger women and some men. Risk factors for SUI include:

  • Gender:  females are more likely to get SUI
  • Pregnancy and childbirth
  • Nerve injuries to the lower back
  • Pelvic or prostate surgery
  • Smoking
  • Chronic coughing

How do I Talk About SUI with my Health Care Provider?

If you think you have SUI, see your health care provider. That is the only way to know for sure. Your health care provider can help you find relief.

You may not feel comfortable talking about your SUI symptoms. A little planning will make you more confident. Here are some tips to help you talk openly with your health care provider:

Be Prepared

Before you visit with your health care provider, gather information. Write down your experiences and questions and bring this with you. Your notes will help you remember what you want to say. Make lists of:

  • Prescription drugs, over-the-counter-medicines, vitamins and/or herbs you take
  • Past and current illnesses or injuries
  • Your symptoms and how they affect you
  • Questions you want to ask

Bring a Friend

If you don't mind sharing this health information with a relative or good friend, ask someone to go with you to your vist. An "appointment buddy" can help remind you of things to say and questions to ask. A "buddy" can be a second set of ears and can take notes to help you remember what your health care provider said.

Bring up the Topic

If your health care provider doesn't ask you about SUI symptoms, bring up the topic. Don't wait until the end of your visit. Talk about it early on. That way there will be time for questions. If a nurse meets with your first, tell the nurse about your symptoms.

Take Notes

Bring a pad of paper and a pen to take notes.

Speak Freely

Tell your health care provider about your symptoms. Talk about how they are changing your life. Share your feelings. Your health care provider is used to hearing all kinds of problems. Before your vist, think about what you want to say and be ready to talk freely. Some peple find it helpful to share the answers to these questions with their health care provider:

  • Is SUI stopping me from doing things outside of my home?
  • Am I afraid to be too far from a bathroom or change of clothes?
  • Have I stopped exercising or playing sports?
  • Have I changed the way I live because I am afraid of urine leakage?
  • Have I become uncomfortable with myself and my body?
  • Have my symptoms changed my relationship with friends or family?
  • Am I avoiding sex because I am worried that I may leak urine and be embarrassed?

Ask Questions

The best way to take control over SUI is to ask every question you have.  A visit to your health care provider is the right time to ask questions. It is best to write down what you want to ask in advance. Bring this list with you to your visit.

Talk About Follow-up Care

Ask your health care provier when you should make your next appointment. Ask what you should bring to that visit



How is SUI Diagnosed?

After you talk about your symptoms, your health care provider may do a physical exam. You may need other tests or a separate appointment to see if you have SUI. You may be sent to a specialist, such as a urologist or female pelvic medicine and reconstructive surgeon. Some urologists and female pelvic medicine and reconstructive surgeons specialize in incontinence and SUI.

Here are some things your health care provider may do to find the cause of SUI:

Your Medical History

Your health care provider will ask about your symptoms, how long you’ve had them, and how they’re are affecting you. A medical history will include questions about:

  • Your past and present health problems
  • Over-the-Counter and prescription drugs you usually take
  • Your diet
  • How much and what kinds of liquids you drink daily

You maybe embarrassed answering questions about leakage or giving your medical history. But health care providers are used to hearing about all kinds of problems. They are there to help you, not judge you. This information will help find the best way to treat your problem.

The Physical Exam

Your health care provider may do a pelvic exam to learn how strong your pelvic floor muscles and sphincter muscles are. For women, your physical exam may include checking your abdomen, the organs in your pelvis, and your rectum. For men, a physical exam may include checking your abdomen, prostate and rectum.

Pad Test

You might be asked to wear a pad while doing an activity or exercising. The pad is then weighed to learn how much you leak during physical activity.

Bladder Diary

Your health care provider may ask you to keep a "bladder diary". This can keep track of your day-to-day symptoms. In your diary, you will record what fluids you drink and how often you go to the bathroom. You also need to note when you have leaks. Include what you were doing when the leak happened, such as exercising, coughing or sneezing.

Other Testing

Your health care provider may also ask for:



How is SUI Treated?



Lifestyle Changes

What Lifestyle changes can treat SUI?

Absorbent Pads

You may need to rely on absorbent pads regularly or from time to time. You may also use absorbent pads when waiting to have surgery or during recovery from surgery. Absorbent pads come in different sizes and styles. Some are simply an adhesive pad, others are pull-on briefs. These may work for you, or you may decide that absorbent pads alone don't provide enough control.

For more information, on the absorbent products, visit our page on managing incontinence with products and devices.

Pelvic Floor Muscle Exercises (also called Kegel exercises)

Kegels are exercises to strengthen your pelvic floor muscles. You can contract (squeeze) and relax the pelvic floor muscles many times each day. Pelvic floor muscles help support the bladder and other organs. Exercising these muscles can make them stronger and help reduce or eliminate your SUI symptoms. To get the most benefit, do these exercises every day!

To make sure you excercise the right musclles, your health care provider may send you to a physical therapist who specializes in strengthening pelvic muslces.

Read the “Strengthening Your Pelvic floor Muscles” article or "Bladder Control:  Strengthening Your Pelvic floor Muscles" brochure to learn more. Do the exercises daily!

Helpful Fluids and Irritating Foods

If you have SUI, you may need to keep track of what you drink. You may need to limit caffeine or other drinks that irritate the bladder. These include some fruit juices, sodas, coffee and tea. Some people are surprised to learn that they should drink more water. Six to eight glasses of water per day is recommended. This helps your body produce diluted urine, which can be less irritating.

Certain foods can be irritating and may need to be avoided like chocolate, citrus fruits and spicy food. Not all people are bothered by these things. The only way to know if diet is a factor is to stop eating known irritants. Then see if leaks are reduced. Constipation can make incontinence worse. Reducing constipation can prevent leaks. It helps to eat high fiber foods to encourage regular bowel movements. Drinking six to eight glasses of water each day also helps.

Maintaining a Healthy Weight

People who are overweight or obese are more likely to develop SUI. This may be because the extra weight puts more pressure on the bladder and pelvic floor. Many people find that losing just 10 pounds can result in fewer leaks. Your health care provider can help you set realistic goals. Every small step towards your healthy weight is worth the effort.

Bladder Training/Bladder Diary

A bladder diary is the starting point for bladder training. You record how much you drink, when you urinate, and when leaks occur. The diary allows you and your health care provider to see how often you urinate now and whether bladder training can help you.

With bladder training, your health care provider may ask to follow a fixed schedule to urinate. You may be asked to lengthen the time between bathroom visits small amounts over time. It is important to try this only if your health care provider tells you to. Some people have more urine leaks when they wait too long to go to the bathroom.

Quit Smoking

Quitting smoking is one of the most important things you can do for your health. A chronic cough from smoking increases leaks. When you quit smoking, you can treat the chronic cough. This helps to reduce pressure on the pelvic floor muscles, which reduces leaks.



Medical Devices

Devices to Control SUI in Women

These kinds of devices only work for females who have SUI

Vaginal Devices for SUI

If your pelvic muscles are weak and you are female, you may benefit from inserting a device in your vagina to prevent SUI. Examples of devices are tampons, over-the-counter pessaries and fitted pessaries. The device presses against the wall of the vagina and the urethra. The pressure helps reposition and support the urethra. This leads to less leakage.

If you use any kind of vaginal device regularly to treat your SUI, you should watch for possible vaginal irritation. Also watch for vaginal or urinary tract infections. Some devices are disposable after one use, others require regular cleaning. If you use one of these devices see your health care provider regularly to check for irritation or infection.

Tampons

Some women find that inserting a tampon during exercise prevents leakage. But tampons have not been approved for this purpose. There is no research on how good tampons are at preventing leaks.

Vaginal Pessaries to Treat SUI

A vaginal pessary is a firm yet flexible device inserted into the vagina. It repositions and supports the urethra and/or uterus. There are different types of pessaries.

Disposable Pessaries Sold Without a Prescription

A single use, disposable pessary was recently approved for use in the U.S. It is available over-the-counter without a prescription. You insert the device with an applicator, like a tampon. Once the pessary is in the vagina, the core and cover of the device support the urethra.

Disposable devices are made to be used for a maximum of 8 hours in a 24-hour period. You remove it from the vagina using a pull string. It is thrown away after use. Some women like how easy these are to use.  All pessaries have some risk of irritation or infection. If you notice this, let your health care provider know.

Prescription Pessaries Fitted by a Health Care Provider

The incontinence pessary is a small device, often made of silicone. You insert it into your vagina. Your pelvic floor muscles hold it in place. These must be fitted just for you by a specialist. When fitted properly, you won't notice that it's there. You can go about daily activities comfortably.

Some women wear the pessary 24 hours a day. They visit their provider to have them removed, checked and replaced. Other women wear them during the day and remove them at night. The pessary must be removed before having sexual intercourse. It does not interfere with pelvic floor muscle exercises. Pessaries are safe, but they have a small risk of irritation or infection. If you use a pessary, visit your health care provider regularly. That way it can be checked, cleaned, and refitted as needed.

Urethral Devices

To help reduce leakage during high activity, you may have the option of a urethral device, also called an occlusive device. They are often shaped like a thin flexible rod. When inserted into your urethra, they can block leaks at times of high activity. Like a tampon, they are removed by pulling on an attached string.

The devices can feel irritating at first. But most women adjust to them. They should not be worn all the time because they can irritate the urethra. This could lead to blood in the urine (hematuria) and urinary tract infections. The devices are useful for reducing urinary leakage during strong physical activity such as running, repeated lifting or playing tennis.



Surgery

Surgery to Control SUI

Deciding about Surgery

If you and your health care provider decide on surgery, there are several options. Start by asking a few questions so you and your health care provider can make the best decision for you:

  • Which surgery is best for me?
  • What are the risks with surgery?
  • Will surgery fix my SUI?
  • How long is the recovery?
  • Will my insurance pay for surgery
  • Should I do this now, or wait?

Deciding about surgery is a personal matter. Learning as much as you can before you start helps you feel more confident about your treatment plan. Explain your goals and expectations to your health care provider. Find out how much the treatment is expected to reduce urine leaks. Learn what to expect during and after surgery. Also ask about possible complications.

Postponing Surgery

Waiting to have SUI surgery won’t harm you. Unlike some other medical conditions,  delaying SUI surgery won't change the result.

Types of Surgery for SUI

There are different types of surgery to help treat SUI for men and women. Talk to your health care provider about your options. Learn more about the risks, recovery, and expected results

  • Surgery for men or women with SUI-Urethral Bulking
  • Surgery for women with SUI
  • Surgery for men with SUI
  • After surgery for SUI

Surgery for Men or Women with SUI-Urethral Injections

Urethral Injections
Urethral Injections
National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health

Urethral injections are used to “bulk up” the muscle valve that keeps the bladder closed. “Bulking agents” are injected into the urethra and bladder sphincter. This improves the function of the sphincter that helps close the bladder.

The injections are done under local anesthesia in your health care provider’s office. The injections can be repeated if needed. This method may not be as effective as other surgeries, but the recovery time is short. Of every 10 men or women who have these injections, between 1 and 3 are cured of urine leaks.

See also:

  • Surgery for women with SUI
  • Surgery for men with SUI
  • After surgery with SUI

Surgery for women with SUI

Surgery for SUI in women is usually very successful. But choosing the right kind is important. If you want to find out more about SUI surgery, ask your health care provider what kind may work best for you.

Slings

Sling Surgery for Urinary Incontinence
Sling Surgery for Urinary Incontinence
National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health

The most common surgery for SUI in women is “sling” surgery. In this surgery, a small strip of material (a sling) is placed under your urethra to give support to prevent leakage. The urethra is the tube that carries urine out of the body. Slings can be made from your own tissue, donor tissue, or surgical mesh. For more information about mesh sling surgery, see our Surgical Mesh for SUI Fact Sheet.

The surgeon makes a small cut (incision) in the vagina. The sling is then inserted under the urethra. This surgery can be done in about 30 minutes without a large incision. Recovery from sling surgery is shorter than other options (like bladder neck suspension surgery).

You can expect many fewer leaks (or no leaks) after recovering from this surgery.

Bladder Neck Suspension

Burch Suspension for Urinary Incontinence
Burch Suspension for Urinary Incontinence
National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health

Bladder Neck Suspension is also called Retropubic Suspension, Colposuspension, or Burch Suspension. It is not as common as ‘sling’ surgery. In this surgery, the urologist cuts through the lower belly. He or she sews the neck of the bladder to the back of the pubic bone for support. This procedure can provide long-term benefits to many women. However, it requires more time to recover than sling surgery.

See also:

  • Surgery for men or women with SUI- Urethral Injections
  • After surgery for SUI

Surgery for Men with SUI

There are surgical options specifically for men with SUI. Talk with your health care provider to find out which treatments may work best for you.

Artificial Sphincter

Nerves carry signals from the brain to the bladder and sphincter
Nerves carry signals from the brain to the bladder and sphincter
National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health

Artificial Urinary Sphincter
Artificial Urinary Sphincter
National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health

The most effective treatment for male SUI is to implant an artificial sphincter device. This surgery places a device with three parts into your body:

  1. A fluid-filled cuff (artificial sphincter}, is surgically attached around your urethra.
  2. A fluid-filled, pressure-regulating balloon is inserted into your belly.
  3. A pump you control is inserted into your scrotum.

When you use the pump, the fluid in the balloon is transferred to the cuff of the artificial sphincter. This closes your urethra and prevents leakage of urine.

This surgery can cure or greatly improve urinary control in more than 7 out of 10 men with SUI. Results may vary in men who have had radiation treatment. They also vary in men with other bladder conditions or who have scar tissue in the urethra.

Male Sling for SUI

A sling may also be used to treat men with mild SUI. In this surgery, a small strip of material (a sling) is placed under your urethra to give support and prevent leakage. Most commonly, slings are made of surgical mesh. The sling is surgically placed between your scrotum and rectum.

The male sling is most often useful in men with mild to moderate leakage who have not had radiation therapy to the prostate or urethra.

See also:

  • Surgery for men and women with SUI- Urethral Injections
  • After surgery for SUI


Lifestyle Changes

What Lifestyle changes can treat SUI?

Absorbent Pads

You may need to rely on absorbent pads regularly or from time to time. You may also use absorbent pads when waiting to have surgery or during recovery from surgery. Absorbent pads come in different sizes and styles. Some are simply an adhesive pad, others are pull-on briefs. These may work for you, or you may decide that absorbent pads alone don't provide enough control.

For more information, on the absorbent products, visit our page on managing incontinence with products and devices.

Pelvic Floor Muscle Exercises (also called Kegel exercises)

Kegels are exercises to strengthen your pelvic floor muscles. You can contract (squeeze) and relax the pelvic floor muscles many times each day. Pelvic floor muscles help support the bladder and other organs. Exercising these muscles can make them stronger and help reduce or eliminate your SUI symptoms. To get the most benefit, do these exercises every day!

To make sure you excercise the right musclles, your health care provider may send you to a physical therapist who specializes in strengthening pelvic muslces.

Read the “Strengthening Your Pelvic floor Muscles” article or "Bladder Control:  Strengthening Your Pelvic floor Muscles" brochure to learn more. Do the exercises daily!

Helpful Fluids and Irritating Foods

If you have SUI, you may need to keep track of what you drink. You may need to limit caffeine or other drinks that irritate the bladder. These include some fruit juices, sodas, coffee and tea. Some people are surprised to learn that they should drink more water. Six to eight glasses of water per day is recommended. This helps your body produce diluted urine, which can be less irritating.

Certain foods can be irritating and may need to be avoided like chocolate, citrus fruits and spicy food. Not all people are bothered by these things. The only way to know if diet is a factor is to stop eating known irritants. Then see if leaks are reduced. Constipation can make incontinence worse. Reducing constipation can prevent leaks. It helps to eat high fiber foods to encourage regular bowel movements. Drinking six to eight glasses of water each day also helps.

Maintaining a Healthy Weight

People who are overweight or obese are more likely to develop SUI. This may be because the extra weight puts more pressure on the bladder and pelvic floor. Many people find that losing just 10 pounds can result in fewer leaks. Your health care provider can help you set realistic goals. Every small step towards your healthy weight is worth the effort.

Bladder Training/Bladder Diary

A bladder diary is the starting point for bladder training. You record how much you drink, when you urinate, and when leaks occur. The diary allows you and your health care provider to see how often you urinate now and whether bladder training can help you.

With bladder training, your health care provider may ask to follow a fixed schedule to urinate. You may be asked to lengthen the time between bathroom visits small amounts over time. It is important to try this only if your health care provider tells you to. Some people have more urine leaks when they wait too long to go to the bathroom.

Quit Smoking

Quitting smoking is one of the most important things you can do for your health. A chronic cough from smoking increases leaks. When you quit smoking, you can treat the chronic cough. This helps to reduce pressure on the pelvic floor muscles, which reduces leaks.



Medical Devices

Devices to Control SUI in Women

These kinds of devices only work for females who have SUI

Vaginal Devices for SUI

If your pelvic muscles are weak and you are female, you may benefit from inserting a device in your vagina to prevent SUI. Examples of devices are tampons, over-the-counter pessaries and fitted pessaries. The device presses against the wall of the vagina and the urethra. The pressure helps reposition and support the urethra. This leads to less leakage.

If you use any kind of vaginal device regularly to treat your SUI, you should watch for possible vaginal irritation. Also watch for vaginal or urinary tract infections. Some devices are disposable after one use, others require regular cleaning. If you use one of these devices see your health care provider regularly to check for irritation or infection.

Tampons

Some women find that inserting a tampon during exercise prevents leakage. But tampons have not been approved for this purpose. There is no research on how good tampons are at preventing leaks.

Vaginal Pessaries to Treat SUI

A vaginal pessary is a firm yet flexible device inserted into the vagina. It repositions and supports the urethra and/or uterus. There are different types of pessaries.

Disposable Pessaries Sold Without a Prescription

A single use, disposable pessary was recently approved for use in the U.S. It is available over-the-counter without a prescription. You insert the device with an applicator, like a tampon. Once the pessary is in the vagina, the core and cover of the device support the urethra.

Disposable devices are made to be used for a maximum of 8 hours in a 24-hour period. You remove it from the vagina using a pull string. It is thrown away after use. Some women like how easy these are to use.  All pessaries have some risk of irritation or infection. If you notice this, let your health care provider know.

Prescription Pessaries Fitted by a Health Care Provider

The incontinence pessary is a small device, often made of silicone. You insert it into your vagina. Your pelvic floor muscles hold it in place. These must be fitted just for you by a specialist. When fitted properly, you won't notice that it's there. You can go about daily activities comfortably.

Some women wear the pessary 24 hours a day. They visit their provider to have them removed, checked and replaced. Other women wear them during the day and remove them at night. The pessary must be removed before having sexual intercourse. It does not interfere with pelvic floor muscle exercises. Pessaries are safe, but they have a small risk of irritation or infection. If you use a pessary, visit your health care provider regularly. That way it can be checked, cleaned, and refitted as needed.

Urethral Devices

To help reduce leakage during high activity, you may have the option of a urethral device, also called an occlusive device. They are often shaped like a thin flexible rod. When inserted into your urethra, they can block leaks at times of high activity. Like a tampon, they are removed by pulling on an attached string.

The devices can feel irritating at first. But most women adjust to them. They should not be worn all the time because they can irritate the urethra. This could lead to blood in the urine (hematuria) and urinary tract infections. The devices are useful for reducing urinary leakage during strong physical activity such as running, repeated lifting or playing tennis.



Surgery

Surgery to Control SUI

Deciding about Surgery

If you and your health care provider decide on surgery, there are several options. Start by asking a few questions so you and your health care provider can make the best decision for you:

  • Which surgery is best for me?
  • What are the risks with surgery?
  • Will surgery fix my SUI?
  • How long is the recovery?
  • Will my insurance pay for surgery
  • Should I do this now, or wait?

Deciding about surgery is a personal matter. Learning as much as you can before you start helps you feel more confident about your treatment plan. Explain your goals and expectations to your health care provider. Find out how much the treatment is expected to reduce urine leaks. Learn what to expect during and after surgery. Also ask about possible complications.

Postponing Surgery

Waiting to have SUI surgery won’t harm you. Unlike some other medical conditions,  delaying SUI surgery won't change the result.

Types of Surgery for SUI

There are different types of surgery to help treat SUI for men and women. Talk to your health care provider about your options. Learn more about the risks, recovery, and expected results

  • Surgery for men or women with SUI-Urethral Bulking
  • Surgery for women with SUI
  • Surgery for men with SUI
  • After surgery for SUI

Surgery for Men or Women with SUI-Urethral Injections

Urethral Injections
Urethral Injections
National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health

Urethral injections are used to “bulk up” the muscle valve that keeps the bladder closed. “Bulking agents” are injected into the urethra and bladder sphincter. This improves the function of the sphincter that helps close the bladder.

The injections are done under local anesthesia in your health care provider’s office. The injections can be repeated if needed. This method may not be as effective as other surgeries, but the recovery time is short. Of every 10 men or women who have these injections, between 1 and 3 are cured of urine leaks.

See also:

  • Surgery for women with SUI
  • Surgery for men with SUI
  • After surgery with SUI

Surgery for women with SUI

Surgery for SUI in women is usually very successful. But choosing the right kind is important. If you want to find out more about SUI surgery, ask your health care provider what kind may work best for you.

Slings

Sling Surgery for Urinary Incontinence
Sling Surgery for Urinary Incontinence
National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health

The most common surgery for SUI in women is “sling” surgery. In this surgery, a small strip of material (a sling) is placed under your urethra to give support to prevent leakage. The urethra is the tube that carries urine out of the body. Slings can be made from your own tissue, donor tissue, or surgical mesh. For more information about mesh sling surgery, see our Surgical Mesh for SUI Fact Sheet.

The surgeon makes a small cut (incision) in the vagina. The sling is then inserted under the urethra. This surgery can be done in about 30 minutes without a large incision. Recovery from sling surgery is shorter than other options (like bladder neck suspension surgery).

You can expect many fewer leaks (or no leaks) after recovering from this surgery.

Bladder Neck Suspension

Burch Suspension for Urinary Incontinence
Burch Suspension for Urinary Incontinence
National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health

Bladder Neck Suspension is also called Retropubic Suspension, Colposuspension, or Burch Suspension. It is not as common as ‘sling’ surgery. In this surgery, the urologist cuts through the lower belly. He or she sews the neck of the bladder to the back of the pubic bone for support. This procedure can provide long-term benefits to many women. However, it requires more time to recover than sling surgery.

See also:

  • Surgery for men or women with SUI- Urethral Injections
  • After surgery for SUI

Surgery for Men with SUI

There are surgical options specifically for men with SUI. Talk with your health care provider to find out which treatments may work best for you.

Artificial Sphincter

Nerves carry signals from the brain to the bladder and sphincter
Nerves carry signals from the brain to the bladder and sphincter
National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health

Artificial Urinary Sphincter
Artificial Urinary Sphincter
National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health

The most effective treatment for male SUI is to implant an artificial sphincter device. This surgery places a device with three parts into your body:

  1. A fluid-filled cuff (artificial sphincter}, is surgically attached around your urethra.
  2. A fluid-filled, pressure-regulating balloon is inserted into your belly.
  3. A pump you control is inserted into your scrotum.

When you use the pump, the fluid in the balloon is transferred to the cuff of the artificial sphincter. This closes your urethra and prevents leakage of urine.

This surgery can cure or greatly improve urinary control in more than 7 out of 10 men with SUI. Results may vary in men who have had radiation treatment. They also vary in men with other bladder conditions or who have scar tissue in the urethra.

Male Sling for SUI

A sling may also be used to treat men with mild SUI. In this surgery, a small strip of material (a sling) is placed under your urethra to give support and prevent leakage. Most commonly, slings are made of surgical mesh. The sling is surgically placed between your scrotum and rectum.

The male sling is most often useful in men with mild to moderate leakage who have not had radiation therapy to the prostate or urethra.

See also:

  • Surgery for men and women with SUI- Urethral Injections
  • After surgery for SUI


After Surgery for SUI

The goal of any treatment for incontinence is to improve your quality of life.  Treatments usually work especially when combined with lifestyle changes. It's important to be careful about how much fluid you drink. You also need to plan to urinate regularly. It's also important to maintain a healthy weight. A large amount of weight gain or activities that strain your belly and pelvis may harm surgical repair over time. Common sense and care will help the benefits from these surgeries last long-term.

Overtime, the medical devices implanted with surgery may need adjustments. Stay in touch with your health care provider about follow-up care.

In most cases, great improvements and even cure of all leaks are possible for people who choose SUI surgery.



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Frequently Asked Questions (FAQ)

It's Time to Talk About SUI Frequently Asked Questions

Questions to ask your health care provider about SUI

Questions to ask your health care provider when being diagnosed:

  • What is causing my urine leakage problem?
  • Do you think that I have SUI?
  • What have my test results showed?

Questions to ask your health care provider about non-surgical treatment:

  • What are my treatment choices, other than surgery?
  • What are each treatment's benefits and risks?
  • Do you recommend one option for me over another?

Questions to ask about surgery:

If your health care provider recommends surgery, these questions may help you talk with your provider:

Surgery Choices

  • What are my surgery choices?
  • What surgery do you recommend for me and why?
  • How likely is a cure or improvement for me
  • What are the risks?
  • How long will this treatment last?
  • For slings: what type of sling material is the best choice for me and why?
  • Is this surgery covered by my insurance?
  • How many of these surgeries have you done, and how many do you perform yearly?
  • What happens if I don't do this surgery now?

Pre-Surgery

  • Is any testing needed before surgery?
  • Can you explain the test results to me?
  • What kind of anesthesia will I need for this surgery?
  • Should I get a second opinion? Why or why not?

Post-Surgery

  • How will I feel right after my surgery? In the first week? From then on?
  • What is the recovery time?
  • Will I be limited in any way and for how long? Can I drive?
  • When can I go back to work?
  • What can I do to improve my quality of life now?