Urethral suspension is a surgery to correct stress
in women. The procedure creates support for the tube that carries urine out of the body. The tube is called the urethra.
Female Bladder and Urethra
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The goal of this surgery is to place a sling under the urethra. The sling will close off the urethra during stressors like laughing or sneezing. This will stop the uncontrolled leaking of urine.
Complications are rare, but no procedure is completely free of risk. If you are planning to have a urethral suspension, your doctor will review a list of possible complications, which may include: BleedingInfectionReactions to anesthesiaInability to urinateContinued incontinence or recurrence of the problemDamage to other nearby organs or blood vesselsPain such as during sexual intercourse
Sometimes, a surgical mesh is used in this procedure. This mesh has been linked to some problems during recovery. Talk to your doctor about medical devices used during surgery.
Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications such as:
SmokingDrinkingChronic disease such as diabetes or obesity
Prior pelvic or vaginal surgery may increase the risk of complications.
Your doctor will try to find out why you are leaking urine through some or all of the following: Medical history—information about medications, illnesses, number of pregnancies, and previous surgeries; pattern of leaking and how it is affecting your lifeUrine sample—to look for the presence of infection or other problemsPhysical exam—includes a rectal and vaginal exam
Additional testing may be ordered to evaluate bladder function and urine flow, such as:
Urine flow studies—a temporary catheter is placed to study bladder functionCystoscopy
—a procedure done to view the inside of the bladder
Steps to take leading up to surgery:
Talk to your doctor about your medications. You may be asked to stop taking some medications up to one week before the procedure, like:
Anti-inflammatory medications, such as ibuprofen
Anti-platelet medicationsArrange for a ride home from the hospital.Do not eat or drink anything after midnight the night before.
One or two small incisions will be made in the abdominal wall and vagina. A sling will be placed under the urethra and stitched into place. The sling can be made out of a synthetic material or tissue from your own body.
After surgery, you will be monitored in a recovery room. You will most likely have a catheter in place to drain your urine.
Anesthesia will block pain during the surgery. After surgery, you may experience some pain or soreness. You will be given
to relieve the discomfort.
You may be sent home the same day.
At first, your urine may look bloody. This will resolve over time.
When you are able to empty your bladder completely, the catheter will be removed. You may be asked to get up and walk around.
During your stay, the hospital staff will take steps to reduce your chance of infection such as: Washing their handsWearing gloves or masksKeeping your incisions covered
There are also steps you can take to reduce your chances of infection such as: Washing your hands often and reminding visitors and healthcare providers to do the sameReminding your healthcare providers to wear gloves or masksNot allowing others to touch your incisions
Certain steps will allow healing to take place. General steps include: Avoid lifting and strenuous exercise for six weeks after surgery.Ask your doctor about when it is safe to shower, bathe, or soak in water.Ask your doctor when it will be safe to have sex or use tampons.
To help ensure a smooth recovery, follow your doctor's
After you leave the hospital, contact your doctor if any of the following occurs: Signs of infection, including fever and chillsRedness, swelling, increasing pain, excessive bleeding, or any discharge from the incision sitePain that you cannot control with the medications you have been givenCough, shortness of breath, or chest painSevere nausea or vomitingTrouble urinatingPain, burning, urgency, or frequency of urination
In case of an emergency, call for medical help right away.
Incontinence. American Urological Association Foundation website. Available at:
Updated March 2013. Accessed December 2, 2013.
Incontinence. American Association of Family Physicians website. Available at:
http://familydoctor.org/familydoctor/en/diseases-conditions/urinary-incontinence.html. Updated July 2010. Accessed December 2, 2013.
Surgical mesh. US Food and Drug Administration website. Available at:
http://www.fda.gov/MedicalDevices/Safety/AlertsandNotices/ucm142636.htm. Updated September 24, 2013. Accessed December 2, 2013.
Surgical treatment for female stress urinary incontinence. National Association for Continence website. Available at:
http://www.nafc.org/bladder-bowel-health/types-of-incontinence/stress-incontinence/surgical-treatment-for-female-stress-urinary-incontinence. Accessed December 2, 2013.
Townsend MK, Danforth KN, et al. Physical activity and incident urinary incontinence in middle-aged women.
J Urol. 2008;179:1012-1016; discussion 1016-1017.
6/3/2011 DynaMed's Systematic Literature Surveillance
http://www.ebscohost.com/dynamed: Mills E, Eyawo O, Lockhart I, Kelly S, Wu P, Ebbert JO. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis.
Am J Med.
Last reviewed December 2013 by Adrienne Carmack, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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