When is surgery used to treat urinary incontinence and overactive bladder?

Surgery is usually considered a last resort after all other treatments have been tried for urinary incontinence or overactive bladder (OAB). But in some cases, when incontinence is caused by a bladder that has moved out of place, surgery may be the best option. The most common surgeries for incontinence involve lifting and supporting the bladder -- either with sutures, tape, or a sling -- closer to its original position.

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Surgery for urinary incontinence is generally recommended only after other measures such as pelvic floor exercises or medication have failed to provide enough help. The trend in surgery for incontinence is toward less invasive surgical procedures that can usually be performed on an outpatient basis and sometimes in the physician's office. Because some surgical procedures for stress incontinence (leaking when coughing or jumping) are now relatively quick and require less recovery time, your doctor may recommend surgery earlier if your incontinence is caused by a repairable structural problem or if it seems unlikely that nonsurgical approaches will be satisfactory. When choosing to have a minimally invasive surgery, it is especially important that your surgeon be highly trained and experienced in the specific procedure you choose.