What Is Stress Urinary Incontinence?
Stress urinary incontinence is involuntary leakage of urine with coughing, laughing, sneezing, lifting, or exercise. It occurs when pelvic floor muscles or urethral support structures are weak, allowing urine to escape during activity. SUI is common in women after childbirth or menopause and occasionally occurs in men after prostate surgery. While pelvic floor therapy is the first-line treatment, surgery is effective when conservative measures don't provide adequate relief.
Surgical Treatment Options
Mid-Urethral Slings
A sling is a small piece of material placed under the urethra to support it during activity and prevent leakage. The sling is anchored to pelvic structures. Modern slings are minimally invasive and provide excellent long-term relief. Success rates exceed 80-90%, and most women are satisfied with results.
Bulkamid Injections
Bulkamid is a bulking agent injected around the urethra to add support and increase outlet resistance. The procedure is performed through cystoscopy and is minimally invasive. Results are good for mild to moderate SUI, though effects may require repeat injections over time.
Why Surgery Works
- High success rates — 80-90% of patients achieve significant improvement
- Minimally invasive options — slings are placed through small incisions
- Permanent results — especially with slings
- Improves quality of life — return to exercise, activities without worry
- Well-tolerated — most women recover quickly and experience minimal complications
Who Is a Candidate?
Surgery is considered when conservative treatment (pelvic floor therapy, lifestyle modification, medications) hasn't provided adequate relief after 3-6 months. Dr. Libby will discuss your symptoms, perform urodynamic testing if needed, and help you decide between sling and Bulkamid based on severity and preferences.
What to Expect
Before Surgery
You'll have a thorough evaluation including pelvic exam, urinalysis, and sometimes urodynamics to confirm diagnosis. Dr. Libby will discuss the surgical options and answer your questions. Plan for someone to drive you home after surgery.
During Surgery
Sling placement takes 30-45 minutes under general or regional anesthesia. Small incisions are made, and the sling material is placed under the urethra and anchored. Proper tension is critical for success. Bulkamid is performed through cystoscopy under anesthesia and takes 15-20 minutes.
Recovery
Most women go home the same day or next day. You may have mild discomfort, urinary urgency, or spotting for a few days. Avoid heavy lifting and strenuous activity for 4-6 weeks. Most women notice immediate improvement, with full benefit by 6-8 weeks.
Restore Your Confidence and Freedom
Stress incontinence doesn't have to limit your activities. Dr. Libby's expertise with slings and Bulkamid ensures excellent results and patient satisfaction. If conservative treatment hasn't worked, schedule a consultation to discuss surgical options.