Urinary incontinence

Surgery for symptomatic SUI is offered if you wish to have surgery and conservative management such as weight loss and physiotherapy treatment has failed. The most appropriate surgical treatment for you is based on a number of factors including your age, previous surgical history, general health, and the severity and type of incontinence you are experiencing. Most surgical options aim to support the bladder neck or partially obstruct the urethra. Surgery is usually not recommended for a woman who may want to have a further pregnancy, as this may cause the woman to become incontinent again.

There are four different operations to treat stress urinary incontinence. Surgical procedures include:

• Mid-urethral tapes using mesh, e.g. Tension-free vaginal tape (TVT)
• Colposuspension: open or laparoscopic
• Injection of bulking agent into the neck of the bladder

• Rectus fascial sling (we do not currently offer this procedure)

The decision to perform a continence surgery is made only after a thorough discussion with you. The choice of treatment depends on the nature and extent of the problem, as well as your personal circumstances.

The guidance from NICE provides more details of the different types of surgery for this condition and helps you make a decision about the procedure that is right for you.

Surgery may be considered if conservative and medical measures for urgency and urge incontinence have not been successful.

• Botox treatment to the bladder
• Sacral nerve stimulation