This is not an exhaustive list but includes some of the common procedures carried out by Ipswich Urology.

Incontinence Treatments and Investigations

Urodynamics is a special investigation of the function of the bladder. It helps to accurately diagnose problems with bladder filling and emptying. A consultant will decide if you need to have such an investigation. It is performed in the clinic and will last upto and hour. A very small tube is passed, under local anaesthetic, into the bladder via the urethra (waterpipe) and this is used to slowly fill the bladder with water while at the same time measuring the pressures in the bladder. Once your bladder is full you will be asked to pass water around the tube. This test is sometimes performed in conjunction with x-rays of the bladder (videourodynamics) and allows a very comprehensive assessment of bladder function and need for surgery.

Botox Injection - involves multiple injections of botulinum toxin into the lining of the bladder wall. This is actually the same "Botox" which is used for cosmetic treatment of skin wrinkles. The procedure is usually performed under general anaesthetic via a cystoscope (telescope passed into the bladder). It is very effective for the treatment of overactive bladder for patients who have not responded to medication. Repeat injections are usually required.

TVT or Trans-Vaginal Tape - is a minimally invasive surgical procedure for the treatment of stress incontinence. It involves placing a nylon-like mesh tape around the urethra (waterpipe). Most of the surgery is performed via a small incision in the vagina and 2 small (1cm) incisions in the abdomen (lower tummy). This is performed under anaesthetic and usually requires an overnight stay.TOT or Trans-Obturator tape is similar to TVT (see above) and differs in the exact positioning of the tape.

Intraurethral injection - involves the injection of a gelatinous (jelly-like) substance under the lining of the neck of the bladder and the top of the urethra (waterpipe). It acts as a bulking agent and is used as a treatment for stress incontinence but only in very specific cases. This procedure is usually performed under anaesthetic.

Other Bladder Procedures

Flexible cystoscopy - This is a telescopic examination of the bladder and urethra (waterpipe). This is performed as a day case, using local anaesthetic and involves passing a narrow flexible telescope down the waterpipe into the bladder.

Rigid cystoscopy - This is a telescopic examination of the bladder and urethra (waterpipe). This uses a wider rigid telescope and requires a general anaesthetic. A rigid cystoscope can be used to carry out additional procedures such as biopsies (removal of pieces of tissue to send for microscopic examination), and removal of bladder tumours or stones.

Radical cystectomy - is a major operation to remove the whole bladder usually as treatment for more serious invasive bladder cancers. This operation includes a reconstructive procedure to drain the urine either into a bag (ileal conduit) or sometimes to make a artificial bladder (neobladder) using a portion of bowel.

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