What are the main types of female incontinence?
- Stress incontinence: for example, leaking urine when coughing.
- Pregnancy, childbirth, the menopause, hysterectomy and obesity can all lead to stress incontinence.
- Urge incontinence: where a patient has an overactive bladder
Sudden urgency, which can result in leaking.
- Mixed incontinence: a combination of stress incontinence and overactivity.
Female incontinence treatment
We offer the full range of treatments, from non-invasive therapies to advanced surgical techniques, which are designed to treat patients individually, according to their symptoms and type of condition. In some cases, symptoms of incontinence are caused by a urinary tract infection or cystitis.
Treatment may include non-invasive therapies including behavioural therapy, pelvic floor exercises and medication and invasive treatments including acupuncture, minimally invasive techniques and surgery.
We offer continuous support, ensuring you are looked after at all times, using minimally invasive approaches where possible, and find an effective solution for you.
Tension free vaginal tape – transobturator route (TVT-O)
A tension free obturator tape is a treatment for stress incontinence, the leakage of urine, which occurs with activity such as coughing, lifting or sneezing. TVT-O is a newer alternative to the tension free vaginal tape (TVT). Both treatments are designed to act like a hammock, supporting the urethra and helping it to close more tightly when the abdominal pressure is raised during coughing or exercising. The tape stays in place permanently.
Fitting a transobturator tape
The procedure takes place under a general or spinal anaesthetic. A small incision (about 2 cm) is made in the vagina just below the opening of the urethra and a polypropylene tape (similar to the material used for surgical sutures) is passed outwards through small (0.5 cm) incisions made in the inner thigh. The tape is positioned without tension under the urethra and acts as a ‘backboard’ to support the urethral continence mechanism (sphincter) when coughing. The incisions are the closed with dissolvable stitches which disappear within 2-3 weeks of surgery. The TVT-O procedure takes about 30 minutes.
How effective is transobturator tape in curing incontinence?
Stress incontinence is common after childbirth with more than one-third of women having some degree of leakage. In these women, TVT-O is effective with over 80% completely dry or much improved after surgery. Most women are able to be as active as they like after placement of a transobturator tape, for example, lifting children, dancing or exercising. As a result, 18 out of every 20 women are satisfied by the results of the procedure. TVT-O is not a treatment for urge incontinence. In women who have an overactive bladder as well as stress incontinence, secondary medicine or neuromodulation treatment may be required to treat urge symptoms.
What should I expect immediately after the procedure?
When you return to the ward, a catheter is present. This is a tube temporarily draining the bladder. The catheter is usually removed after a few hours. Once you have passed urine, you can leave the ward and go home. This may be the same day, or sometimes the day after the operation. If the operation has been combined with a procedure for prolapse, you will probably be in hospital for a longer period of time. Your stitches will dissolve spontaneously within two to three weeks.
London Urology provides a full service for people suffering with Female Incontinence. In particular,Mr Jeremy Ockrimis a specialist in this area and is able to offer expert advice and treatment methods to suit your individual needs. To book an appointment you can email [email protected] or call 020 7432 8297