Stress Urinary Incontinence

This condition causes women to lose urine accidentally when they cough, sneeze, laugh or with just about any activity that causes pressure on the bladder.  

Most women have at least heard of kegel exercises.  For mild symptoms, pelvic floor exercises practiced regularly and properly may help improve symptoms.

Vaginal inserts such as tampons and a Poise product called Impressa help with leaking, usually for specific occasions or during exercise.

For women who need guidance learning to perform pelvic floor exercises, nurses or physical therapist can offer direct instruction using biofeedback.

Reusable vaginal inserts called pessaries can also provide relief for some women.

Transurethral bulking.  Many women qualify for an injectable procedure called transurethral bulking that allows for rapid return to activity with a high satisfaction rate.  The injectable agent Bulkamid fills the space around the urethra (the tube you pee through) helping to prevent urine from accidentally escaping.  Done either in the office or a surgery center, women experience minimal discomfort and generally return to normal activities very quickly.  

Midurethral slings.  Developed in the mid 90's, slings continue to be the main treatment for SUI.  This outpatient procedures successfully treats SUI in 95% of women who undergo this surgery.  Women go home from the surgery the same day and return to routine activities rapidly.  

Burch urethropexy and Pubovaginal slings.  Although less commonly performed, these remain good options for women who have specific situations or concerns.  The Burch procedure supports the bladder neck using permanent sutures and can be performed laparoscopically or robotically.  Pubovaginal slings use a strip of tissue from the patient or a biologic graft to support the bladder neck.  Each of these procedures have good success rates but do require slightly lengthier procedures.  Both procedures are day surgeries.