If incontinence is having a major negative impact on your life, and no treatments help, it might be time to consider surgery.
Although it is invasive and has a higher risk of complications than other therapies, urinary incontinence surgery can also provide a long-term solution for severe or persistent cases.
Your surgical options depend on the type of urinary incontinence you have. Most options for urinary incontinence surgery treat stress incontinence. However, surgical alternatives are available for other bladder problems, including urge incontinence.
When is surgery required?
There’s a range of surgical procedures to treat bladder related conditions and you should consult your doctor about what is best for you.
- Stress incontinence most often results from weakening of the pelvic floor muscles and connective tissue supporting the bladder. There are two surgical procedures that can be done – colposuspension repairs the bladder neck, and bladder suspension surgery (also known as sling suspension) repairs the pelvic floor.
- Surgery for urge incontinence is rare. Urge incontinence occurs when the bladder walls involuntarily contract, creating an overwhelming urge to go to the toilet, with incontinence often a result. Other treatments including medications are usually first line therapies, but bladder augmentation surgery is sometimes suggested as a last resort measure.
- Prolapse is the protrusion of the pelvic organs into the vaginal canal and even outside the vagina. It happens when the pelvic floor becomes weakened or damaged. There are various surgical procedures and approaches depending on your age, whether you wish to keep your womb and which organ or organs have prolapsed. Most procedures involve repairing the structures supporting the vaginal wall.
- Bladder surgery can also be performed to remove cancerous tissue and tumours on the bladder wall. This is called transurethral surgery and is used in early stage cancer patients. Sometimes, if the cancer is advanced, part of the bladder is removed (partial cystectomy) or, if it’s very advanced, the whole bladder is removed. This is called a radical cystectomy and will often require additional reconstructive surgery for urine diversion.