Stress incontinence

Stress urinary incontinence is defined as a sudden unintentional loss of urine during normal day to day activities. If you have this problem you may notice leakage if you laugh, cough, sneeze, walk, exercise, or lift something.

Common questions

What is treatment for stress incontinence?

Your bladder and urethra are supported by your pelvic floor muscles and ligaments. If this support is weakened, urine leaks with coughing, sneezing, laughing or with lifting and exercising.

Why would I have treatment for stress incontinence?

If you find that urine is leaking when you cough, sneeze, laugh or with other exertion.

What happens during treatment for stress incontinence?

There are a wide range of treatments for stress incontinence at Benenden Hospital – and our urogynacologists will help you decide which treatment will be the most effective.

We can advise on non-surgical treatments, such as pelvic floor muscle exercises - which are the most effective non-surgical treatment. Weight loss is also an effective treatment option for overweight women with stress urinary incontinence.

Drug treatment, in the form of Duloxetine tablets may also be a suitable option for some women.

Surgical treatments include: Transvaginal Tape operations (TVT), Urethral bulking or Bulkamid, fascial sling operations or colposuspension operations.    

TVT involves placing a piece of synthetic mesh material, like a sling, under your urethra to support it. Over the past few years, concerns have been raised about the safety of using mesh materials in the vagina, which are used to treat both incontinence and prolapse, and most of the problems have arisen after its use to treat prolapse. We recognised this problem many years ago and have inserted very few vaginal meshes to treat prolapse. Our Urogynacologists are members of the British Society of Urogynacologists (BSUG) and therefore adhere to the highest standards of care. Tapes are thin pieces of mesh and are used to treat incontinence. There are 2 ways to insert tapes: “Retropubic route” and “Trans-obturator route”. Trans-obturator tapes are not performed at Benenden, we only insert tapes through the safer retropubic route.

Urethral bulking or Bulkamid is a relatively non-invasive surgical treatment option for stress incontinence and an alternative to surgery.   This treatment involves injecting the bladder neck (through the urethra) with a bulking substance which obstructs the flow of urine. Usually performed under local anaesthetic, this procedure has a success rate of 50-60%. Repeat injections may be required to maintain this benefit. Women can normally return to work after a day or two. The long-term outcome of bulking is not well known. The implanted substance is intended to be permanent and there is no long-term data on safety.

Fascial sling operation. This is an operation in which a strip of tissue is removed from the lower wall of the abdomen and used like a hammock to support the urethra. It is an alternative to using a synthetic mesh, but data is inconclusive.

What should I expect after treatment for stress incontinence?

Depending on the treatment you choose, you will be given information on what to expect after your treatment. You will be referred to the Gynae/Urology Specialist nurses after procedures for bladder retraining, pelvic floor muscle exercises and further advice about aftercare.

Contact Benenden Hospital

It’s easy to make an appointment; you can ask your GP or give us a call on 01580 230661.