Christian Seipp MD PhD
Consultant Urological Surgeon
Getting you dry with involve a step-by-step approach: behavioural modifications such as changing what you drink, how to manage fluids throughout the day and how often you empty your bladder may help reducing your leakage.
The second step consists of pelvic floor rehabilitation in an attempt to strengthen your pelvic floor muscles. Physiotherapy (occasionally with bio-feedback and electrostimulation) will teach you how to improve the support structures that prevent your bladder from leaking.
If conservative treatment fails, you might need to consider surgery to regain full bladder control: in mild cases it might be sufficient to inject bulking agents around the urethra to act like a cushion, thus adding "bulk" to the bladder outlet.
In other cases small tapes can be inserted underneath the urethra. These act almost like a hammock, supporting urethra and bladder neck and helping it to close more tightly when the abdominal pressure is raised during coughing or exercising. These tapes are called TVT (tension-free vaginal tape) or TOT (transobturator tape). The placement of these tapes involves a small surgical procedure under general or spinal anaesthetic. The postoperative recovery is very fast and the surgery is usually extremely successful with excellent long-term results.