Key facts about managing bladder incontinence 2 - Surgery options

Maintaining continence: Surgery 1

What other surgical procedures are available for improved bladder continence?
The decision to proceed with surgical intervention is a complex one, and must be tailored to suit each individual. Procedures are constantly improving so it is worth keeping up to date by asking your urologist about developments when you visit. It is also one of the reasons you must have regular urological tests.

The following is a list of common urological procedures used in spina bifida.

Vesicostomy: What is it?
The bladder is directly connected to the skin by a stoma. Urine drains directly out.

Why have it?
When there is poor bladder emptying with UTIs and back pressure (reflux) to the kidneys.

Augmentation cystoplasty: What is it?
The bladder is made bigger by sewing on a piece of bowel, stomach, or urinary system tissue.

Why have it?
When there is bad back pressure (reflux) to the kidneys.

The Mitrofanoff procedure/catheterisable stomas for the bladder: What is it?
The appendix is used to connect the bladder to the skin. The bladder can then be cathed via the stoma (hole) in the skin through the appendix.

Why have it?

When the urethra is blocked and cathing is impossible or when the person can’t cath for some other reason.

Maintaining continence: Surgery 2
Transurethral injection: What is it?
The sphincter (ring of muscle) that stops urine from leaking out of the bladder is injected to tighten it up.

Why have it?

When there is leakage (incontinence) from a floppy sphincter that does not close well.

Slings: What are they?
A sling, often made of tendon, is looped under the bladder around the urethra. This operation is generally done in women.

Why have it?

When there is leakage (incontinence) from a floppy sphincter that does not close well.

Artificial urinary sphincters: What are they?
An artificial sphincter often made of silicon is inserted to help close a floppy sphincter. This procedure is usually done in men.

Why have it?

When there is leakage (incontinence) from a floppy sphincter that does not close well.

Circumcision: What is it?
The foreskin of the male penis is cut away

Why have it?
When the foreskin is ‘gummed down’ and causes UTIs or prevents cathing or interferes with having normal erections.
If you cannot easily pull your foreskin back over the head of your penis, see your doctor.