Secondary Treatments for Stress Urinary Incontinence

Secondary Surgical Treatment Options for SUI

Autologous Pubo-Vaginal Sling

An alternative to the urethral sling, the autologous pubo-vaginal sling is an option for women who do not wish to have the more common mesh sling implanted. This
procedure utilizes the patient’s own fascia (connective tissue), taken from the thigh or lower pelvic area, to create the sling. Because your doctor uses your own tissue, there is no reaction to synthetic materials. The procedure, which is a more invasive, intricate surgery than a urethral sling, involves a small vaginal incision as well as two small incisions made above the pubic bone to insert and place the sling. A small incision in either the thigh or lower pelvis is also made to harvest the tissue.

Retropubic Suspension Surgery (Burch procedure)

In some women, the bladder neck and urethra have dropped into the pelvic area, which causes involuntary urine leakage. Retropubic suspension surgery is a
less common procedure that treats SUI by lifting the sagging bladder neck and urethra by attaching the bladder to structures behind the pubic bone to provide
added support. This procedure is typically performed laparoscopically or through open surgery under general anesthesia through several small incisions in the abdomen. 

Radiofrequency Bladder Neck Suspension

A less common alternative treatment, radiofrequency bladder neck suspension is a minimally invasive procedure where the pelvic tissue is gradually and precisely heated, allowing it to shrink and stabilize to keep the urethra from leaking. Your doctor may offer this therapy as a clinical trial or it may be offered off trial based on your insurance.