Urinary Incontinence: What Is It?

Urinary incontinence is a common health problem that affects many women’s quality of life. It can range from mild leakage to severe loss of bladder control. In cases where medication and exercises fail to provide control, surgical treatments can deliver highly effective results.

Types of Urinary Incontinence and When Surgery Is Needed

Not every case requires surgery. However, surgery may be necessary in the following situations:

• ✅ When medication and pelvic floor exercises are ineffective
• ✅ When urinary incontinence negatively impacts daily life
• ✅ When pelvic organ prolapse is also present

Types of urinary incontinence:

• Stress type: Leakage during coughing, sneezing, or exercise.
• Urge type: Sudden, strong urge to urinate followed by leakage.
• Mixed type: Combination of both stress and urge types.

Surgical Methods

TOT (Transobturator Tape) Surgery

How is it done? Small incisions are made in the vagina and groin area, and a synthetic sling (mesh) is placed under the bladder.

• ✅ Procedure time: 20–30 minutes
• ✅ Quick recovery with small incisions
• ✅ Discharge on the same day or the next day

Recovery: Light activities in 1 week, sexual activity after 4–6 weeks.

TVT (Transvaginal Tape) Surgery

How is it done? A thin tape is placed under the bladder through an incision inside the vagina. Similar to TOT, but provides firmer support.

• ✅ Procedure time: 30–45 minutes
• ✅ Fast recovery and return to daily life

Recovery: Mild pain may last for a few days, full recovery in 4–6 weeks.

Mini-Sling Surgery (Minimally Invasive)

How is it done? Can be performed with smaller incisions, sometimes even under local anesthesia.

• ✅ Shorter procedure time
• ✅ Lower risk
• ✅ Short hospital stay

Recovery: Return to daily life within 1 week, sexual activity after 3–4 weeks.

Burch Colposuspension

How is it done? The bladder neck is lifted through an abdominal incision, usually laparoscopically.

• ✅ Long-term effectiveness
• ✅ Effective for stress-type incontinence

Recovery: Return to normal in 1–2 weeks, full recovery in 6 weeks.

Artificial Urethral Sphincter

How is it done? An inflatable device is implanted around the urethra. The patient activates the device when they want to urinate.

• ✅ Preferred in severe cases where other treatments have failed

Recovery: Return to daily life within 3–6 weeks.

Post-Surgery Recovery

First Days After Surgery

• Mild abdominal and vaginal pain may occur
• Light vaginal bleeding and burning sensation while urinating may be experienced

Return to Daily Life

• Walking helps support recovery
• Avoid heavy lifting during the first week
• Sexual activity is usually recommended after 4–6 weeks

Long-Term Recommendations

• Perform Kegel exercises regularly
• Avoid constipation
• Excessive weight, strenuous exercise, or heavy lifting may cause recurrence

Who Is Surgery Not Suitable For?

• 🚫 During pregnancy
• 🚫 In cases of active urinary tract infection
• 🚫 In severe organ prolapse (may require additional procedures)

Conclusion

Urinary incontinence is a condition that lowers women’s quality of life but can be permanently treated with surgery. Methods such as TOT, TVT, mini-sling, Burch colposuspension, and artificial sphincter are selected based on the individual patient. Consulting a gynecologist or urogynecology specialist will help determine the most appropriate surgical method for you. Modern surgical options are safe and effective for a healthier and more comfortable life.