For 42-year-old runner Karen Metler, urinary incontinence had posed a challenge during her first marathon and threatened her aspiration to run a second. The federal accountant from Dunkirk had been waging a silent battle against urinary leaking whenever she laughed, coughed or sneezed. Director of the Women’s Center for Pelvic Health, Briana Walton, MD, diagnosed Karen with urinary stress incontinence and recommended a sub-urethral sling procedure. The outpatient surgery requires just two small incisions through which a supportive mesh sling or hammock is placed around the bladder neck and urethra. The results are immediate. Karen went on to complete the Marine Corps Marathon and was so pleased, she brought her marathon finish photo to her one-year follow-up visit. “I completely attribute being able to run again with ease to the procedure,” she said.