Urinary incontinence remains a topic that both patients and clinicians find difficult to discuss and manage. Following the NICE guidance published in 2006, a well-defined structure for the management of urinary problems was outlined. Conservative measures are the mainstay for all patients, with anticholinergic drugs playing a major role in the management of over-active bladder and urge incontinence.
Surgical management is an area that continues to grow and develop. The types of procedures offered to patients have changed dramatically in the last 10–15 years, with the advent of tension-free vaginal tapes and more recently the use of botulinum toxin. It is important that health professionals encountering patients with incontinence are aware of the common urological/gynaecological operations available, the place of surgical options in the overall pathway, and the benefits as well as the risks associated with continence surgery. This article provides the non-specialist with an overview of the available surgical options for management of continence.