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Urinary incontinence - or passing urine unexpectedly - can be embarrassing. Many women experience it because of weak pelvic muscles - typically caused by pregnancy and child birth. It can also be caused by old age, obesity, and family history.

Previously, this potentially unpleasant condition could only be repaired with major surgery but we now offer relatively minor surgical solutions. An even less invasive injection treatment is also available. These interventions strengthen the urethra (the tube through which urine leaves the body) and do not usually require an overnight stay.

Why you might need it

Unexpected and uncontrolled urinating can be embarrassing and often distressing. Stress urinary incontinence (more commonly called stress incontinence) occurs when urine leaks from your bladder as you laugh, cough or lift a heavy object.

It occurs when the pelvic floor muscles and the urethral sphincter muscle that keep the bladder closed are weak.

Pelvic floor exercises with the help of a specialist physiotherapist or continence nurse may help to improve symptoms of stress incontinence. Traditionally, the only other treatment option was major pelvic floor surgery. However, in the last few years, two relatively simple and highly effective surgical procedures have been developed to treat stress incontinence: TVT and TOT. Both use medical tape to help support your urethra.

Another, non-surgical alternative is to have an injection of bulking agents into the urethra to help correct urinary incontinence. This procedure takes just 15 minutes and you can leave hospital as soon you have urinated normally. 

Who will do it?

Our patients are at the heart of what we do and we want you to be in control of your care. To us, that means you can choose the consultant you want to see, and when you want. They'll be with you every step of the way.

All of our consultants are of the highest calibre and benefit from working in our modern, well-equipped hospitals.

Our consultants have high standards to meet, often holding specialist NHS posts and delivering expertise in complex sub-speciality surgeries. Many of our consultants have international reputations for their research in their specialised field.

Before your treatment

You will have a formal consultation with a healthcare professional. During this time you will be able to explain your medical history, symptoms and raise any concerns that you might have.

We will also discuss with you whether any further diagnostic tests, such as scans or blood tests, are needed. Any additional costs will be discussed before further tests are carried out.

During this appointment you and your consultant can discuss which of the three procedures is the best option for you. Both TVT and TOT techniques give similar results and your surgeon will be able to explain the differences between the two methods in more detail.

 

Preparing for your treatment

We've tried to make your experience with us as easy and relaxed as possible.

For more information on visiting hours, our food, what to pack if you're staying with us, parking and all those other important practicalities, please visit our patient information pages.

Our dedicated team will also give you tailored advice to follow in the run up to your visit.​

The procedure

We understand that having any medical procedure, even one as relatively straightforward as this, can cause anxiety. Our experienced and dedicated medical staff will be there to reassure you throughout.

TVT or TVT-O

You will have discussed with your expert consultant at your initial appointment whether you’ll have a local, spinal or general anaesthetic for your TVT or TVT-O procedure.

In the TVT (tension-free vaginal tape) procedure the tape is inserted through a small cut within the vagina. The tape is then pulled through two tiny cuts on the skin, just above your pubic area. The tape acts as a sling to hold your urethra up. Your surgeon will snip the tapes, just under the skin, and close the cuts using dissolvable stitches. Your body makes scar tissue that grows into the tape and keeps it in place. This gives extra support for your urethra. The operation takes about half an hour.

A newer technique is called TVT-O (for obturator) or TOT (trans obturator tape). In the TOT procedure a similar cut in the vagina is made, but the tape ends pass out of the pelvis through a muscle called the obturator, to the skin surface via a small cut on each inner thigh.

Both operations take about half an hour.

Bulking injection

Bulking agents are designed to "tighten" the urethra to treat urinary incontinence. The bulking agents, such as collagen, are injected into the urethra by the consultant. Your consultant will use a cystoscope (a thin optical tube) to inject the substances directly into your urethra.

You don’t need any anaesthetic or sedation, although the latter can be administered if you feel you need it. If you want to be sedated you should raise this during your initial meeting with the consultant.

The procedure usually takes about 15 minutes, with no sedation required. Patients can go home as soon as they show they can urinate normally.

Aftercare

If you have a bulking injection you’ll be able to leave hospital as soon as you pass urine normally. For most people, this will be the first time they urinate after the injection.

Similarly, most people who have a TVT or TVT-O are able to leave hospital on the same day. Because you’ll be feeling drowsy after the anaesthetic you’ll need a friend or relative to take you home.

After this, you will be taken to your room or comfortable area where you can rest and recuperate until we feel you’re ready to go home.


Pain relief

If you had TVT or TVT-O you will feel some tenderness and soreness around the sites of the cuts. We’ll give you pain relief medication while you are with us and advice on painkillers when you leave.  

We will provide you with a supply of all the medicines your consultant feels you need to take home with you after you've left hospital, up to 14 days. This may be at an additional cost to some patients.

If you have a bulking injection you may experience a burning sensation when you urinate or have blood in your urine for a short time.


Recovery time

After a TVT or TVT-O operation you will probably need to take up to a week off work. You should avoid strenuous exercise and lifting for four to six weeks.


End result

It’s likely that you’ll stop urinating unexpectedly immediately after each of these procedures.


Looking after you

Even once you’ve left hospital, we’re still here for you. If you have TVT or TVT-O your consultant is likely to want to see you after your treatment to see how you're doing. A follow up appointment will be made before you leave the hospital.

On rare occasions, complications following treatment can occur. The chance of complications depends on the exact type of operation you are having and other factors such as your general health. We will talk to you about the possible risks and complications of having this procedure and how they apply to you.

If you have any questions or concerns, we’re ready to help.

How much does it cost?

A fixed price for this treatment may be available on enquiry and following an initial consultation.

We are committed to delivering excellent individual care and customer service across our network of hospitals, clinics and specialist care centres around the UK. Our dedicated and highly trained team aim to achieve consistently excellent results. For us it's more than just treating patients, it's about looking after people.

Important to note

The treatment described on this page may be adapted to meet your individual needs, so it's important to follow your healthcare professional's advice and raise any questions that you may have with them.

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