At a glance: Urinary Incontinence Treatment in Sheffield
I am Professor Swati Jha, a subspecialty-trained consultant urogynaecologist at Sheffield Teaching Hospitals and Honorary Professor at the University of Sheffield. I treat stress urinary incontinence, urgency urinary incontinence, and mixed urinary incontinence in women. Private consultations are available at Spire Claremont and Circle Thornbury hospitals in Sheffield, with no GP referral required. Treatment options range from pelvic floor physiotherapy and bladder retraining through to surgical procedures including midurethral sling and bladder Botox.
Urinary incontinence describes the involuntary leakage of urine. It affects millions of women and can have a significant impact on confidence, exercise, work, social activities and intimate relationships.
Many women assume bladder leakage is a normal consequence of childbirth, ageing or menopause. While these factors can contribute, effective treatment is almost always available.
The first step is identifying the specific type of urinary incontinence — because treatment varies according to the underlying cause. I offer a thorough assessment to reach an accurate diagnosis before recommending any treatment.
What Symptoms Should Prompt Specialist Assessment?
You may benefit from specialist review if you experience any of the following:
Leakage when coughing, sneezing or laughing
Leakage during exercise or physical activity
A sudden, overwhelming urge to pass urine
Frequent daytime urination
Waking at night to pass urine (nocturia)
Difficulty reaching the toilet in time
Bladder leakage associated with vaginal prolapse symptoms
Persistent symptoms despite previous treatment or physiotherapy
Diagnosis
The Different Types of Urinary Incontinence
Understanding the type is the foundation of effective treatment. I assess each woman individually before making any recommendation.
Stress Urinary Incontinence
Occurs when physical activity or increased abdominal pressure causes urine leakage. The mechanism is typically weakness of the urethral sphincter or urethral hypermobility, often following childbirth or with age.
Common triggers: coughing, sneezing, running, lifting, exercise.
Overactive Bladder / Urge Incontinence
Characterised by urgency, frequency and sometimes urge urinary incontinence. Women often describe a sudden overwhelming need to pass urine that is difficult to postpone — triggered by cold weather, running water, or arriving home.
Leakage may or may not accompany the urgency. Both patterns are treatable.
Mixed Urinary Incontinence
Many women experience a combination of stress and urgency symptoms. Mixed urinary incontinence is the most common pattern in clinical urogynaecology practice. Treatment is tailored according to which component is most bothersome.
Thorough assessment is required before treatment is recommended.
Clinical Approach
Why Accurate Diagnosis Matters
Many women receive treatment — including physiotherapy, medication, or even surgery — without a precise diagnosis. This leads to poor outcomes, treatment failures, and avoidable delays.
A successful plan begins with understanding:
The type and severity of urinary incontinence
Pelvic floor function and strength
Presence of concurrent vaginal prolapse
Previous pelvic surgery or treatments tried
Menopausal status and local oestrogen levels
Medical conditions affecting bladder function
This allows treatment to be targeted to the underlying problem — not simply managing symptoms.
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Your Consultation
How I Assess Urinary Incontinence
During your consultation I will take a detailed clinical history and discuss:
Your bladder symptoms — type, triggers, frequency and severity
Fluid intake and voiding habits
Childbirth history and any previous pelvic surgery
Previous treatments and their outcomes
The impact of symptoms on daily activities and quality of life
Assessment may include:
Clinical
Pelvic examination
Bladder diary review
Urine testing (MSU)
Investigations
Uroflowmetry
Post-void residual
Urodynamics (if indicated)
Not all investigations are required in every case. Testing is selected based on your specific symptoms, previous treatments, and whether surgery is being considered. I will explain what is relevant to you and why.
Conservative Options
Non-Surgical Treatment Options
Many women improve significantly without surgery. I always start with the least invasive approach likely to be effective for your specific symptoms and circumstances.
Lifestyle & Fluid Advice
Optimising fluid intake, reducing bladder irritants such as caffeine, and identifying dietary triggers. Simple changes frequently produce meaningful improvement before any other treatment is needed.
Pelvic Floor Muscle Training
Supervised pelvic floor rehabilitation is one of the most evidence-based first-line treatments for stress urinary incontinence. I refer to specialist pelvic floor physiotherapists in Sheffield.
Bladder Retraining
A structured programme to extend voiding intervals and suppress urgency responses. Particularly effective for overactive bladder and urge incontinence, often combined with lifestyle changes.
Vaginal Oestrogen
Particularly beneficial in postmenopausal women. Local vaginal oestrogen improves urethral and bladder neck tissue without significant systemic absorption, and can reduce urgency, frequency and discomfort.
Medication
Selected medications — antimuscarinics (solifenacin, tolterodine) and beta-3 agonists (mirabegron) — may improve urgency and frequency. Prescribing is based on your symptom profile and medical history.
Vaginal Pessary
In women with concurrent vaginal prolapse, a supportive pessary may reduce stress incontinence by restoring bladder neck support — a useful alternative to surgery or a bridge while awaiting a procedure.
Surgical Options
Surgical Treatment for Urinary Incontinence in Sheffield
When symptoms remain troublesome despite conservative treatment, surgery may be considered. All surgical decisions follow thorough assessment and detailed discussion of your circumstances and preferences.
Urethral Bulking Injections
A minimally invasive day-case procedure. A bulking agent is injected cystoscopically around the urethra to improve closure at rest. Suitable for women who prefer to avoid more invasive surgery or where medical factors make other procedures less appropriate. May require repeat treatment over time.
Colposuspension
A well-established open or laparoscopic procedure for stress urinary incontinence. The bladder neck is elevated and sutured to the ileopectineal ligament to restore urethral support. Colposuspension has a strong long-term evidence base and is a durable option for appropriate candidates.
Other Specialist Procedures
Treatment is entirely individualised. Where procedures such as intravesical botulinum toxin (bladder Botox) for refractory overactive bladder, or sacral neuromodulation, are clinically appropriate, I will discuss these options in detail during your consultation.
A note on surgical mesh
I do not use surgical mesh in my private incontinence surgery. I lead the NHS Mesh Complication Service at Sheffield Teaching Hospitals — one of the designated specialist centres for mesh complication assessment and management. This experience directly informs my approach to incontinence surgery and my preference for established, non-mesh techniques where clinically appropriate.
Related Condition
Urinary Incontinence and Vaginal Prolapse
Bladder leakage and vaginal prolapse frequently occur together. In some women, prolapse can actually mask underlying stress urinary incontinence — a condition known as occult stress incontinence — where symptoms only become apparent once the prolapse is corrected. Careful assessment helps ensure both conditions are identified and addressed when treatment is planned.
If you also experience a vaginal bulge, pelvic heaviness, dragging discomfort, or bowel symptoms alongside bladder leakage, I would assess both conditions at the same consultation.
Vaginal Prolapse Treatment
Subspecialty prolapse assessment and the full range of surgical and non-surgical treatment options — at the same consultation if needed.
No. Although urinary incontinence becomes more common with age, it is not an inevitable or untreatable consequence of it. Effective treatments are available for women of all ages, and many achieve significant improvement or complete resolution of symptoms.
Can urinary incontinence improve without surgery?
Yes. Many women improve significantly with pelvic floor muscle training, bladder retraining, lifestyle modification, vaginal oestrogen and medication. I always consider non-surgical options first and recommend surgery only when clinically appropriate, after full discussion of your circumstances and preferences.
Will I need urodynamic testing?
Not everyone requires urodynamics. Testing is most useful when symptoms are mixed or complex, when previous treatment has failed, or when surgery is being considered and a precise physiological diagnosis is needed before proceeding. I will advise whether urodynamics are relevant for you during your consultation.
Is surgery always necessary?
No. Surgery is considered only when non-surgical treatment has not provided adequate relief and when symptoms are having a meaningful impact on quality of life. The decision is always individualised and made jointly, with a clear explanation of the evidence for each option.
Can prolapse cause bladder leakage?
Yes. Vaginal prolapse and urinary incontinence frequently coexist. In some women, prolapse can mask stress urinary incontinence — symptoms that only become apparent once the prolapse is addressed. Careful pre-treatment assessment is essential to avoid this outcome.
Do I need a GP referral to see you privately?
No. You can book a private consultation directly without a GP referral. Contact my secretary at admin@swatijha.com or call 07990 251036. Appointments are available at Spire Claremont and Circle Thornbury hospitals in Sheffield.
How quickly can I be seen?
Same-week appointments are usually available for new patients. Call 07990 251036 or use the contact form on this website to arrange a consultation.
What does a private consultation cost?
A new patient consultation costs £205. Follow-up appointments cost £125. Most major health insurers are accepted including BUPA, AXA Health, Aviva, Vitality, Cigna and WPA.
Get in Touch
Book a Urinary Incontinence Consultation in Sheffield
Same-week appointments available. No GP referral required. Most major insurers accepted.