Symptoms :

• Leaking urine when laughing, coughing or sneezing
• Lack of bladder control (needing to rush to the toilet / know exactly where toilets are in any given moment, known as ‘toilet mapping’)
• The urge to pass urine too often
• The urge to pass urine frequently in the night
• Difficulty emptying the bladder
• Frequent urine infections
• Pain on passing urine

Diagnosis :

Bladder problems can be extremely embarrassing and have a major impact on a woman’s life. Women are therefore often understandably reluctant to discuss these problems with a doctor. We offer a sympathetic approach to this sensitive and upsetting problem. There is also sensitive advice available at the Bladder and Bowel Foundation.The management of bladder problems starts with a careful consultation and gentle examination. Sometimes we ask women to complete a ‘bladder diary’ in addition to urine testing.

Sometimes it may be necessary to perform a urodynamics test (a test to assess bladder functioning) or cystoscopy (a camera to check the inside of the bladder) to determine the exact nature of the problem.

Treatment :

Depending on the diagnosis, bladder problems can often improve with simple lifestyle changes and targeted pelvic floor exercises.

We can arrange expert Pelvic Floor Physiotherapy and also recommend other conservative measures.

such as medication.

Medication :

• Anticholinergics
• Beta 3 Agonists
• Desmopressin
• SSRI's

If these do not help it may be necessary to consider a surgical option

Surgery :

• Bulkamid
• Colposuspension, open or laparoscopic
• Botox

Bulkamid injections since the technique was first introduced in 2006. This technique has recently become much more popular again because of complications with tapes and slings.

It involves injecting a Hydrogel at 3-4 sites around the mid-urethra. This helps the urethra to stay closed during stress. 3 out of 4 women report that their symptoms are improved by this treatment. It only takes 15 minutes and does not seem to have any long term complications.

Colposuspension was the Gold standard treatment for stress incontinence for many years until Tapes took over this mantle in the early 2000's. Now that tapes have fallen into disrepute there is a resurgence in this technique. Mr Barnick has been performing this operation both open and laparoscopically for our 20 years. It is a particularly good choice in women who also have a degree of anterior vaginal wall prolapse.

Botox injections into the bladder can be used to treat intractable urgency and urge incontinence. About 1 in 10 women will temporarily need to catheterise following the procedure. Injections need to repeated every 3-6 months.