FAQ

Stress urinary incontinence (SUI) is the involuntary loss of urine that occurs during physical activity, such as coughing, sneezing, laughing, or exercise. Approximately 1 out of 3 women over the age of 45, and 1 out of every 2 women over 65, have SUI.¹

SUI is the result of weakened muscles that control the storage of urine. Childbirth, in particular, can cause support tissue damage or nerve damage that contributes to the weakening of these muscles. Other factors that predispose women to SUI include obesity and constipation.

UI (urinary incontinence) is a general term for several types of urinary loss. Two of these are SUI (stress urinary incontinence) and UUI (urgency urinary incontinence).

• With SUI (stress urinary incontinence), you leak urine with a physical event that exerts abdominal pressure on your bladder, such as coughing, sneezing, laughing, lifting, or jumping.
• With UUI (urgency urinary incontinence), you leak urine due to a bladder contraction that you cannot control. It is characterized by a feeling of urgency to go to the bathroom before the bladder accident.

You may have one or both of these types of incontinence. You can find more information about symptoms at mayoclinic.org, and you should follow up with your doctor for a proper diagnosis. Your doctor can do simple tests to help confirm your symptoms and determine the cause of your leakage.

Medications
As of today, there are no FDA-approved medications for SUI. There are medications for UUI.

Nonsurgical treatments
Nonsurgical options for treating SUI include pelvic floor exercises, diet and exercise, protective undergarments, behavioral therapy, bulking agents, and pessaries. You should discuss these treatments with your doctor.

Surgical treatments
The definitive treatment for SUI is surgery. The goal of SUI surgery is to provide support for the urethra in order to mitigate bladder leakage. Surgical options fall into two categories:

Midurethral Slings
The midurethral sling (MUS) procedure is the most common surgical procedure for the treatment of SUI.² Making a small incision in the vagina, your surgeon inserts knitted polypropylene material—a mid-urethral sling—under your urethra. Your own tissue grows into the sling and forms a “hammock of support” for your urethra, helping to prevent leakage during effort-related activities.

Polypropylene midurethral slings (both retropubic and transobturator) are seen as the gold standard of treatment of SUI in the United States and the developed world. According to a joint position statement written by two leading professional societies, the American Urogynecologic Society (AUGS) and the Society of Urodynamics, Female Pelvic Medicine and Urogenital Reconstruction (SUFU), “Over 3 million MUS have been placed worldwide and a recent survey indicates that these procedures are used by >99% of AUGS members.”⁴

Nonmesh Surgical Procedures
These surgical options are alternatives to the midurethral sling:

• The Pubovaginal sling procedure uses tissue obtained from you or from donated cadaver tissue.
• Two procedures—the Burch and the Marshall-Marchetti-Krantz—use stitches secured to either a ligament or pubic bone.

For more information about surgical procedures for SUI, please refer to mayoclinic.org or talk with your physician. Your physician is your best resource for determining which treatment is best for you.

This is a decision that should be made by you in consultation with your surgeon. You should discuss all of your options with your surgeon and which treatment plan is most appropriate for your specific medical situation. However, for moderate to severe bladder leakage primarily caused by exertion, the polypropylene midurethral sling has been shown to be the most effective treatment.⁵

Your surgeon makes a vaginal incision of about 1.5 cm (a little over 1⁄2 inch) and, using specially-designed needles, places the sling underneath the urethra. No stitches are needed to secure the sling to your tissue. Your tissue will hold the sling in place initially, and eventually that tissue will grow into the sling, securing it in place, and helping to provide the necessary support that minimizes or prevents leakage.

In most cases, the actual sling surgery should last less than 30 minutes⁶. If your surgeon recommends it, the procedure can be performed on an outpatient basis under local anesthesia with IV sedation. In many cases, sling surgery is performed along with another procedure that your physician may recommend to support a dropped bladder, uterus, or rectum. Your surgeon will discuss these options with you.

Every patient’s recovery experience is unique and your physician will brief you as to what he or she expects in your case. After undergoing a sling surgery, you may experience some minor discomfort and fatigue for the first 24 to 72 hours. Please consult with your surgeon on activities to avoid during recovery to achieve optimal outcomes.

You should have a discussion with your physician about the risks and benefits associated with the placement of a midurethral sling. As with any medical procedure, complications can occur from the surgery. According to the FDA, “the most common complications reported through MDRs for surgical mesh slings for SUI repair, in descending order of frequency, include: pain, mesh erosion through the vagina (also called exposure, extrusion or protrusion), infection, urinary problems, recurrent incontinence, pain during sexual intercourse (dyspareunia), bleeding, organ perforation, neuro-muscular problems and vaginal scarring. Many of these complications require additional medical intervention, and sometimes require surgical treatment and/or hospitalization. With the exception of mesh erosion, the above complications can occur following a non-mesh surgical repair for SUI.”⁷

For a full list of Warnings and Precautions related to each sling, go to section 2.3 of any UroCure IFU. Click here to access the IFUs.

There is no surgery for incontinence that has a 100% cure rate, but sling surgeries for bladder leakage have been performed and studied since the 1990s and have been shown to have high success rates of 80-95%.⁸ Other incontinence procedures are possible after sling placement. If necessary, inform your surgeon about having a sling when considering additional treatment options.

All of UroCure’s slings have been cleared by the FDA. Click on the appropriate link below to read the FDA clearance letter:

ArcTV Clearance Letter

ArcSP Clearance Letter

ArcTO Clearance Letter