Surgical Procedures to Treat Stress Urinary Incontinence in Women

Stress urinary incontinence (SUI) refers to the ‘involuntary loss of urine on effort or physical exertion, or on sneezing or coughing‘.

SUI is the most common type of urinary incontinence, affecting over 10-20% of women.

While stress urinary incontinence can cause great distress and personal embarrassment, it is not an urgent condition and hence there should be ample time to seek advice and guidance on available treatment options.

Depending on the impact of SUI on your quality of life, and your coping mechanisms, treatment options may include: 

  1. Self-management – continence aids https://www.yourpelvicfloor.org/conditions/continence-pads-and-perineal-care/
  2. Non-surgical treatments – lifestyle changes, pelvic floor exercises https://www.yourpelvicfloor.org/conditions/pelvic-floor-exercises/, continence pessaries 
  3. Surgical treatments – The myriad of of surgical treatment options for stress urinary incontinence can be classified according to:
    • surgical route: abdominal, vaginal, laparoscopic
    • anatomical space: retro-pubic, trans-obturator
    • materials used: native tissue, sutures, tapes or slings , urethral bulking agents
    • surgical techniques: colposuspension (laparoscopic or abdominal route, sutures, no mesh), mid-urethral slings (retropubic or trans-obturator, prolene mesh), pubo-vaginal sling (natural tissue eg. rectus sheath), urethral bulking agents  (cystoscopy).

In recent years, there have been many conflicting scientific-medico-legal opinions 2016 AJOG Nager Midurethral slings – evidence-based medicine vs legal system and negative media reports concerning surgical management of pelvic organ prolapse and urinary incontinence https://www.ausdoc.com.au/opinion/what-judge-got-wrong-transvaginal-mesh-device-scandal .

In order to help inform and support women in considering and choosing  the best available surgical treatment  based on scientific evidence, leading national organisations such as The Royal Australian College of Obstetricians and Gynaecologists (RANZCOG),  the Australian Commission for Safety and Quality, and international institutions such as the International Urogynecological Association (IUGA) have  published positional statements and resources available at:

RANZCOG Position statement on MUS-(C-Gyn-32)

ACSQH Patient-information-resource-transvaginal-TV-mesh-Stress-Urina…

IUGA Stress-urinary-incontinence

IUGA Urodynamics