Stress urinary incontinence, or SUI, occurs when urine leaks from the bladder when pressure is exerted in the abdominal area. It can occur when the muscles supporting the urethra or bladder have been weakened. It can make it hard to live a normal life; those with this condition have a difficult time doing simple things such as climbing the stairs, laughing, or sneezing without experiencing urine leakage.

It's nothing to be ashamed of. Just as some lose their ability to see or hear, the urinary tract can stop working perfectly for some people. It is a perfectly natural occurrence and it is no reason to be embarrassed.

Many people think that SUI is a condition associated mainly with aging. This cannot be farther from the truth: SUI affects women young and old. A number of factors could be the culprit, including pregnancy, vaginal childbirth, menopause, gynecologic surgeries, and even strenuous exercise. And, no matter how much you'd want it to, it won't get better on its own.

The ability to hold urine and maintain continence is dependent on normal function of the lower urinary tract, the kidneys, and the nervous system. Additionally, the person must possess the physical and psychological ability to recognize and appropriately respond to the urge to urinate.

The process of urination involves two phases: 1) the filling and storage phase, and 2) the emptying phase. Normally during the filling and storage phase, the bladder begins to fill with urine from the kidneys.

The bladder stretches to accommodate the increasing amounts of urine. The first sensation of the need to urinate occurs when approximately 200 ml of urine is stored. The healthy nervous system will respond to this stretching sensation by alerting you to the need to urinate, while also allowing the bladder to continue to fill.

The average person can hold approximately 350 to 550 ml of urine. The ability to fill and store urine properly requires a functional sphincter muscle, controlling output of urine from the bladder, and a stable bladder wall muscle (the detrusor muscle).

The good news is that SUI is 85%-90% treatable. Most of those who suffer from it can return to normal, active lives.

After a patient has been diagnosed with SUI through urodynamic testing, all of the surgical options available are discussed. The two most commonly used treatment methods are the sling procedure and the Burch procedure, which are the most effective options available according to the American Urology Association. The urodynamic study and physical examination will determine which procedure is best for each patient.

The Sling: One of the most widely used treatments involves a urethral sling that is surgically implanted into the urethra. The sling supports the patient's natural tissue networks, helping the urethra to close completely. This is a minimally invasive surgery that has seen high success rates in treating ISD and hypermobility.

Bone Fixated Slings: These restore bladder control by inserting a graft material into the urethra, giving it a point of support.

The Burch Procedure: Technically known as retropubic suspensions, these treat hypermobility by raising and returning the urethra and the neck of the bladder to a higher position in the body.