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Stress Urinary Incontinence Treatment Options

Decision Aid

Stress incontinence is leakage of urine when you cough/ sneeze/ jump/ laugh or move.
If these aren't your symptoms - talk to your doctor about whether other treatments would be better for you.

What does this treatment involve?

  • Conservative Treatment/No Treatment: Pelvic floor physiotherapy, Weight Loss

  • Mesh Sling: 30-minute operation with the placement of mesh

  • Native Tissue Sling: 75-minute operation with patient's muscle used as a sling

  • Bulking Agent: 15-minute operation with an injection of gel into the lining of the urethra

  • Colposuspension: 60-90 minute abdominal/laparoscopic sutures to re-support the bladder outlet and suspend the vagina from ligaments on the pubic bone.

What is the success rate? 

  • Conservative Treatment/No Treatment: Unknown
  • Mesh Sling: 85%-90%
  • Native Tissue Sling: 85%-90%
  • Bulking Agent: 50% - 60%
  • Colposuspension: 70%

How long does the treatment last? 

  • Conservative Treatment/No Treatment: Unknown
  • Mesh Sling: At least 15 years
  • Native Tissue Sling: At least 15 years
  • Bulking Agent: At least 2 years
  • Colposuspension: At least 15 years

What is the recovery time in hospital?

  • Conservative Treatment/No Treatment: n/a
  • Mesh Sling: Day stay surgery, 4 weeks recovery
  • Native Tissue Sling: 2-3 nights in hospital, 6 weeks recovery
  • Bulking Agent: Day stay surgery, 1-2 days
  • Colposuspension: 2-3 nights in hospital, 6 weeks recovery

What are the mesh related problems that can occur? 

  • Conservative Treatment/No Treatment: n/a
  • Mesh Sling: 1% risk of not being able to urinate, 2% - 5% risk of vaginal exposure
  • Native Tissue Sling: n/a
  • Bulking Agent: n/a
  • Colposuspension: Permanent sutures can cause bone.....

Why might this treatment NOT be right for me? 

  • Conservative Treatment/No Treatment: n/a
  • Mesh Sling: History of radiation, previous mesh problems, history of chronic pelvic pain
  • Native Tissue Sling: History of underactive bladder
  • Bulking Agent: n/a
  • Colposuspension: Extensive previous abdominal surgery

What else should I know? 

Stress incontinence surgical procedures are not designed to help with urinary frequency, urgency (rushing to the toilet or flooding before you get there, not being able to hold on etc). Sometimes they help these symptoms but sometimes they make them worse. 

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