Medical experts usually place incontinence surgery last in the list of steps taken to correct urinary incontinence (loss of bladder control). That's because, for surgery to be successful, doctors must know exactly what is causing the patient's incontinence, and it can be difficult to track down the precise cause. There also are a number of effective non-surgical treatments for incontinence, including medications, bladder training, and Kegel exercises.

If you choose to pursue incontinence surgery, you should do so with an understanding of some of the complications that could occur. Many of these complications are rare, but can happen. Also keep in mind that some kinds of incontinence surgeries, such as sling surgery (raising the urethra and holding it in place with an internal band called a sling) or abdominal bladder suspension surgery (raising the bladder internally and stitching in place), can have success rates as high as 80 to 90 percent.

Incontinence Surgery: Complications

Complications that have been linked to incontinence surgery include:

  • New feelings of urge incontinence. Incontinence surgery is usually used in women to correct stress incontinence (incontinence when the bladder has pressure stressing it, such as during a laugh or cough). Unfortunately, the surgery can result in the patient suffering from urge incontinence, or the sudden and controllable need to urinate. These feelings usually last through recovery, but can continue.
  • Difficulty urinating or inability to urinate. This occurs in incontinence surgeries that involve moving the bladder neck and urethra into a higher position to prevent leakage. Until the body adjusts, women might find it difficult to urinate at all. This complication usually lasts just a week or so.
  • Infection of the wound or of the urinary tract. This is a common surgical complication and can be treated with antibiotics.
  • Fistula. Although they are rare, abnormal openings from the urinary tract into the vaginado develop in some people after incontinence surgery. If left unaddressed, these openings can allow urine to leak out through the vagina. "A fistula usually means that you have an opening from the urethra and/or the bladder to the vagina," says Jean Fourcroy, MD, a Washington D.C. urologist, a consultant to Walter Reed Army Hospital, and former Food and Drug Administration medical examiner. "You would have constant leaking. There would be nothing to stop it."

Incontinence Surgery: Problems with Mesh

The U.S. Food and Drug Administration recently has identified another complication that can occur in sling incontinence surgeries where synthetic surgical mesh is used to make the sling. Problems can occur when the mesh is placed through an incision made in the wall of the vagina.

Doctors have found that in some patients the mesh will erode through the vagina, causing infection, pain, and continued urinary problems. Some experience scarring of the vagina or pain during sex. In other cases, nearby organs like the bowel and bladder were injured. "It's made us rethink the idea of using synthetics at all in the urinary tract," says Craig Comiter, MD, an associate professor of urology at Stanford University Medical Center and a spokesman for the American Urological Association.

If you are having incontinence surgery that features the use of mesh and you've had a past reaction to materials like polypropylene, you should let your surgeon know. You also should ask if the repair can be done without using mesh, and what the surgeon's experience has been in dealing with complications.

In all instances, you should have a frank discussion with your surgeon about what to expect following surgery and possible complications to keep an eye out for.