Tests and treatments

Surgical procedures for urinary incontinence

There are two surgical procedures that can possibly treat urinary leaking or incontinence:

Urethra suspension or mid-urethral sling (TVT, TVT-O, TOT)

What is it?

A mid-urethral sling or mesh works as a support for the bladder at times when there is increased pressure, such as with coughing, sneezing, and shaking. This prevents sagging of the urethra and urine from leaking out of the bladder, and so prevents urinary incontinence. This operation is a solution for stress incontinence.

Course of the procedure

Various methods (so-called TVT, TVT-O, TOT) are used to vaginally place a supportive mesh. This mesh is placed using a small incision in the vaginal wall, usually under general anaesthesia. During the procedure, a urinary catheter is placed, which is then removed one day afterwards. The vaginal sutures are dissolvable, but the sling is permanent. The body absorbs the sling as scar tissue grows in and around the mesh's polypropylene threads.

Botulin (Botox) injections in the bladder

What is it?

For certain types of urge incontinence, the bladder can be injected with Botox. These injections relax the bladder muscle, resulting in less urgency and less urine leakage.

The procedure is performed using cystoscopy: the bladder wall is pricked in several places with a thin needle that administers a small quantity of Botox to the bladder wall. A urinary catheter is normally necessary for this procedure.

Centres and specialist areas

Urology Centre

Latest publication date: 05/02/2021
Supervising author: Dr Ameye Filip