Introduction and Hypothesis <p>Many women require surgical treatment for stress or mixed urinary incontinence. These procedures often improve pre-existing symptoms of urgency urinary incontinence but may also worsen symptoms or cause de novo urgency incontinence. We assessed the prevalence of improvement and deterioration in reported urgency urinary incontinence following primary surgery for stress or mixed urinary incontinence.</p> Methods <p>This registry-based study used data from the local database of the Norwegian Female Incontinence Registry at a regional hospital. Pre- and 6–12&#xa0;months postoperative urgency urinary incontinence scores were compared for tension-free vaginal tape surgery and periurethral injection therapy and related to age and BMI.</p> Results <p>The study included 2710 women treated with retropubic tension-free vaginal tape and 305 women who received periurethral injection with Bulkamid. Preoperatively, 36% and 21%, respectively, had pure stress urinary incontinence while 64% and 79% had mixed urinary incontinence. Postoperatively, 79% reported improvement in urgency incontinence symptoms after tension-free vaginal tape compared with 54% after injection therapy, whereas de novo urgency incontinence was reported by 6% and 20% and worsening of urgency symptoms by 4.2% and 11.8%, respectively.</p> Conclusions <p>Up to 79% of patients with preoperative mixed urinary incontinence experienced improvement in urgency incontinence symptoms following surgery for stress urinary incontinence. However, among women with preoperative pure stress incontinence, 6% developed de novo urgency incontinence after tension-free vaginal tape but 20% did so after periurethral injection therapy with Bulkamid. Preoperative counselling regarding urgency urinary incontinence is essential, particularly for women without preoperative urgency urinary incontinence.</p>