Is Surgery The Answer to Stress Urinary Incontinence?

Imagine this: you’re laughing with friends, sneezing, or lifting something heavy, and suddenly, you feel a small leak. If this sounds familiar, you might be experiencing Stress Urinary Incontinence (SUI). 

SUI happens when the muscles that support your bladder and control urine flow weaken. As a result, any activity that can put pressure on your abdomen causes an involuntary leakage. While SUI might seem frustrating and embarrassing, it’s more common among women than you’d think.

A National Library of Medicine study revealed that about 15.7% of adult women are affected by SUI. The embarrassment surrounding the condition prevents many women from seeking treatment, with only 60% of them bothering to get it treated. 

If you’re among the 60%, we have good news for you. There are various ways to manage SUI, even without surgery. But when does surgery become a necessity? Stay with us as we explore the answer while familiarizing you with other treatment options. 

Non-Surgical Treatment Options for SUI

Whenever a woman suffers from SUI, the conservative methods of its treatment are tried first. These involve options that do not resort to medication or surgery. 

First and foremost, we recommend making lifestyle changes. If you are overweight or obese, it’s a good idea to start with losing weight to avoid undue pressure on your bladder.

Those who consume a high amount of caffeine – through tea and coffee – are asked to limit their caffeine consumption. 

Lastly, drinking either more or less fluid than required on a daily basis can worsen your incontinence. Therefore, you’ll need to monitor your fluid intake closely to make the necessary adjustments.

If none of these lifestyle issues resonate with your experience, here are other non-surgical treatment options you can explore:

Kegel Exercises – Are They Effective? 

Kegel exercises are simple yet powerful moves designed to strengthen your pelvic floor muscles, which support the bladder, uterus, and rectum. These exercises involve contracting and relaxing the muscles you’d use to stop urinating midstream. 

The beauty of Kegels? You can do them anytime, anywhere, and no one will ever know.

When it comes to SUI, Kegel exercises are a go-to recommendation. By consistently practicing Kegels, you can build up the strength of the pelvic floor muscles. 

Stronger pelvic floor muscles do a better job of preventing those unexpected leaks that happen when you cough, sneeze, or laugh. WebMD notes that in addition to SUI, these exercises can prove effective for women suffering from urge incontinence due to an overactive bladder. 

The more you practice, the more control you gain. This makes Kegels an effective, non-invasive way to manage and even reduce the symptoms of SUI over time. So, why not give it a try? Your pelvic floor might just thank you.

The Role of Bladder Training

Bladder training is like giving your bladder a much-needed tune-up. It’s a technique that involves gradually increasing the time between bathroom visits. By training your bladder to hold more urine, you can reduce those sudden urges. Think of it as teaching your bladder who’s really in charge – you.

For those dealing with SUI, bladder training can be a game-changer. By sticking to a strict bathroom schedule and resisting the urge to go “just in case,” you can strengthen your bladder’s capacity over time. 

This means fewer leaks and more confidence in your day-to-day life. While it requires patience and consistency, the payoff is worth it – better bladder control and a lot less worry. 

Pessaries 

Typically made of soft silicone, a pessary is a small, removable device designed to support your pelvic organs, including your bladder, to prevent leakage. These non-invasive devices come in various shapes and sizes, with the ring pessary being the most commonly recommended for SUI.

Cleveland Clinic points out that it might take you a few tries to find the right fit. However, it will ultimately lead to a significant reduction in symptoms, allowing you to regain control and confidence in your daily life​.

Medication

If none of the non-invasive options we’ve discussed above seem to work for you, medication is the final alternative. That is if you don’t want to go through surgery. But we’ll talk more about it later. 

According to the National Health Service (NHS), there is an antidepressant that has proven to manage SUI effectively. Duloxetine – a serotonin-noradrenaline reuptake inhibitor (SNRI) – can treat both nerve pain and SUI in women, besides anxiety and depression. 

Duloxetine is a prescription medication that you can get by your general physician’s (GP) recommendation. However, it’s also known to cause side effects like nausea, fatigue, dry mouth, and constipation in women. If you notice these symptoms consistently after the first couple of weeks, talk to your GP about it. 

When Does Surgery Become a Consideration? 

Surgery for SUI typically becomes a consideration when non-surgical treatments, like Kegels, bladder training, or pessaries, haven’t provided sufficient relief. 

If your daily activities are significantly impacted by frequent leaks, surgery might be the next step. It is also true if you feel like your quality of life is being impacted by the condition. 

Women who suffer from a severe case of SUI and are looking for a long-term solution can also consider a surgical treatment. 

Surgical Intervention – Downsides to Consider

Surgery for SUI might seem like the ultimate fix, but it’s not without its drawbacks. First, there’s the recovery time, which can be lengthy and might keep you from your usual activities. 

Then, there’s the risk of complications, like infection or device failure. TorHoerman Law notes the latter to be true for transvaginal mesh – a medical device used for treating SUI and pelvic organ prolapse (POR). The device has been known to erode over time, leading to infections and injuries in women. 

Many patients have admitted to suffering injuries following device failure after their surgical vaginal mesh placement. In light of these complications, a large group of these women have filed a transvaginal mesh lawsuit against their manufacturer. 

They claim that the manufacturer didn’t perform proper testing of the product before putting it on the market. 

Additionally, no surgery guarantees success – there’s always a chance you might need further treatment down the road. The cost and emotional toll of undergoing surgery aren’t easy to overlook either. Weigh these carefully before deciding if surgery is right for you.

Frequently Asked Questions (FAQs)

Is SUI a permanent condition? 

No, it isn’t. Most women have found subtle lifestyle changes and daily practice of kegel exercises to cure their SUI. However, in some severe cases – mostly in aging women or those with multiple childbirths – only a surgical intervention can fix the condition.

Which age group is most affected by SUI?

SUI commonly affects women who are middle-aged or older, with 40 being its benchmark age. The factors that trigger this condition in women include aging, menopause, and more rarely, multiple childbirth. Some men have been known to suffer from it, too, but it is often related to prostate surgery.

What is Giggle Incontinence?

According to News Medical, giggle incontinence is a specific kind of daytime stress urinary incontinence. In this condition, the involuntary leak is triggered only by bursting, loud, or powerful laughter, with no other functional symptom. Although often mistaken for an overactive bladder, giggle incontinence is not the same.  

SUI might look like an embarrassing condition at first. However, it’s essential to realize that it’s a medical condition and there’s no reason for you to feel hesitant to talk about it. You can seek treatment only once once you’ve accepted it yourself.