Overactive Bladder Therapy

Specialised treatment for overactive bladder and urge incontinence in Johannesburg — when medication hasn't been enough.

Regaining control

Overactive bladder — sudden, hard-to-defer urgency, frequent urination, and sometimes leaking before you reach the toilet — is common in both women and men, under-reported and very treatable. It is different from leaking when you cough, sneeze or exercise (stress incontinence), although the two can occur together. For stress incontinence and incontinence in men, see Urinary Incontinence.

Bladder training and medication are the usual first steps. If they haven’t worked for you, don’t settle: two proven next-line therapies are available in this practice.

Bladder Botox injections

Botulinum toxin injected into the bladder muscle calms the involuntary contractions that cause urgency and leaking.

Done in theatre as a day case, under a short anaesthetic, through a small telescope — no cuts
Improvement is typically noticeable within days to two weeks
The effect usually lasts several months, and the injections can be repeated when symptoms return
A small proportion of patients temporarily need to empty the bladder with a catheter — we will discuss this openly before you decide

Sacral Neuromodulation

Sacral neuromodulation (SNM) uses a small, pacemaker-like device to restore normal communication between the bladder and the brain. I am a Medtronic-accredited proctor for sacral neuromodulation, training other surgeons in the procedure. I am also on the faculty of the yearly InterStim cadaver workshop in Stellenbosch, where new implanting surgeons are trained.

A trial phase comes first: a thin test lead (a "staged, tined lead") is placed next to the nerve that controls the bladder so you can test the therapy in daily life before committing to the permanent device
If the trial works, the small permanent device — the InterStim X, which needs no recharging and allows full-body MRI scans under specified conditions — is placed under the skin
Both stages are day cases under general anaesthetic, at any of my hospitals
It can treat both bladder and bowel control problems — for the right patient, the effect on quality of life can be transformative

Book a consultation: call 011 794 3549 or email appointment@urology.joburg

This information is general in nature and is not a substitute for a consultation.