In a small number of cases, surgery to treat overactive bladder may be recommended if everything else has failed or where there is a blockage such as a stone or another bladder obstruction.

There is another alternative where part of the muscle of the bladder wall is removed to weaken contractions. The use of botox injections into the wall of the bladder to weaken contractions is a newer procedure.

Surgery may also be recommended for stress incontinence if a pelvic exercise programme is not successful or there is prolapse.

There are a number of procedures including:

• bladder neck suspension or sling
• collagen injections around the urethra
• implantation of artificial urinary sphincter or sacral nerve stimulator.

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