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Gynaecologist, Laparoscopic Surgeon
Urinary incontinence in women is a nit infrequent occurrence after childbirth becoming worse with the loss if estrogen to the pelvic floor with the menopause. It has two main types, stress incontinence and urgency, which may occur in the same woman. Stress incontinence is the loss f urine when coughing, sneezing, jumping, running etc and is the type most amenable to surgical treatment. Urgency and Urge incontinence are the inability to hold on when one needs to go!
In my opinion surgery for stress incontinence is recommended when the loss f urine is affecting ones lifestyle: stopping you doing an activity you would like to do, such as netball, dancing, jumpin on the trampoline with the kids, or causing embarrassing accidents with the need to wear a pad constanty. It is also important not to keep emptying the bladder whenever you perceive it beginning to fill simply to avoid an accident, as this is likely to exacerbate any urgency problems which are generally nt amenable to surgical correction.
Fortunately surgery for stress incontinence is relatively straightforward with a high success rate.
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Gynaecologist, Laparoscopic Surgeon
Surgery is only beneficial to treat urinary stress incontinence, the loss of urine when jumping, running, sneezing etc. I reccomend surgical correction after pelvic floor physiotherapy has either failed or is too onerous to continue every day permanently. Surgery has a 90-95% success rate and can be either a laparoscopic Burch colposuspension or a sub-urethral tape, both of which carry the same short and long-term success rates. Surgery IS NOT suitable for urinary urgency, the need to rush to the toilet and not make it in time.
These issues should be discussed with your GP prior to referral to an appropriately trained gynaecologist or urogynaecologist (not all gynaecologists can or should manage these issues) but in general, if urinary loss is limiting your normal activity and you are not doing something you would like to do because of it ( eg dancing, netball, golf), I suggest surgical treatment is the worth considering.
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