Stress incontinence that does not respond to medicine or exercise therapy is often treated surgically. (Surgery is typically not done for urge incontinence.
 
If there may be additional causes of incontinence (mixed incontinence), a complete evaluation and further testing may be done before surgery is considered.

Discuss with your doctor which symptoms the surgery is designed to treat. Other symptoms may remain after surgery. If you have mixed incontinence, surgery may cure stress incontinence, but it may not improve urge incontinence. It may even make urge incontinence worse.

The tension-free vaginal tape (TVT) surgery is often used for stress incontinence. During this surgery, a meshlike tape is positioned under the urethra like a sling or a hammock to support it and return it to its normal position. The surgeon inserts the tape through small incisions in your vagina and pubic hair line. TVT surgery takes approximately 30 minutes and is usually done under local anesthesia. This surgery can also be done to correct incontinence that has come back after having another type of incontinence surgery.
Another surgery called transobturator tape (TOT) surgery is like TVT surgery.

More invasive surgeries include the retropubic suspension surgery and the sling surgery. These surgeries support your pelvic organs and correct stress incontinence.