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Surgery

Urinary tract infections

Surgery is generally not required for urinary tract infections, unless an anatomic abnormality is discovered.

Bladder control problems

Surgery for bladder control problems can correct an anatomical problem or implant a device to alter bladder muscle function. Most people do not need surgery, but most who undergo surgery become dry. Surgery does not work for everyone and carries the possibility of complications, so it is best advised by a urogynecologic or urologic surgeon. Types of operations include the following:

• Altering the bladder neck to change how urine is released from the bladder



• Repairing or supporting severely weakened pelvic floor muscles



• Removing a blockage



• Implanting a "sling" around the urethra



• Implanting a device to stimulate nerves and increase awareness of need to urinate



• Injecting collagen, a naturally occurring material, around the urethra adds bulk to the area and compresses the urethra, thus increasing the resistance to urine flow (used to treat stress incontinence)



• Enlarging the bladder (considered a last resort)

Bladder prolapse

Surgery is often recommended when a prolapsed bladder cannot be managed with a pessary or other approaches. Procedures vary depending on the grade of prolapse. Generally, the prolapsed bladder is repaired through an incision into the vaginal wall. The prolapsed area is closed and the wall is strengthened. Depending on severity, the procedure can be performed with local, regional, or general anesthesia.