What surgical treatments are available for stress incontinence?

If the incontinence is thought to be related to prolapse, vaginal repair surgery (Q30.6) will improve the problem in about 80% of patients. Some surgeons, particularly bladder specialists, may operate through the abdomen rather than the vagina. Stitches are introduced to either side of the urethra and attached to the ligaments or bone at the front of the pelvis (colposuspension). Injections of inert substances can be introduced under the bladder neck. Although with training they are said to be simple to introduce, they are not quite so simple to remove should there be problems. If there is true incontinence associated with a hole in the system (fistula) a urologist (bladder specialist) is likely to be able to close this defect.

For many years a variety of meshes have been introduced under the urethra with varying degrees of success. In the late 90s a simple technique - tension free vaginal tape (TVT) was introduced. A small incision is made under the urethra and the tape is inserted. Some surgeons perform the operation under local anaesthetic. Usually, you can go home the same day.

There are a variety of mechanical aids that put additional pressure on the bladder neck. They are designed to be easy to introduce and remove.

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