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Urinary Incontinence Surgery

Urinary incontinence is involuntary urine leakage. Initial treatment involves lifestyle and exercises; surgery is an option.

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About Urinary Incontinence Surgery

Urinary incontinence is the involuntary leakage of urine, most commonly triggered by physical activity such as coughing, sneezing, laughing, or exercising. It is a common condition, especially among women, and can significantly affect quality of life. The loss of bladder control is often related to weakness in the pelvic floor muscles or dysfunction in the urinary sphincter.

The first line of treatment for urinary incontinence typically includes lifestyle modifications and medications. These may involve:

Pelvic floor muscle training (e.g., Kegel exercises)
Bladder training
Dietary adjustments (reducing caffeine or alcohol)
Medications to relax the bladder or increase sphincter tone

If these conservative measures do not significantly improve symptoms and urinary incontinence markedly disrupts your life, surgical intervention may be considered.

When surgery is required, the goal is to restore support to the pelvic organs, particularly the bladder and urethra, thereby reducing or eliminating urine leakage. Two of the most commonly used surgical approaches are laparoscopic surgery and transvaginal surgery.

The newest treatment for urinary incontinence is the FEMSelect® EnPlace™ Procedure.

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Sub-procedures

The Urinary Incontinence Surgery involves possible sub-procedures. To read more about the applicable sub-procedure(s), please read below.

FEMSelect® EnPlace™ Procedure

The FEMSelect EnPlace procedure is a minimally invasive vaginal surgery designed to treat stress urinary incontinence by restoring support to the urethra. During the short, 30-minute procedure, a small, soft implant is placed through a minor vaginal incision to reinforce the body's natural structures, ensuring the urethra remains closed during physical activities like coughing or exercising. Unlike traditional sling surgeries, this method avoids external incisions and the use of needles behind the pubic bone, leading to reduced surgical trauma, a faster recovery, and a typical same-day discharge for the patient.

Laparoscopic Surgery

Laparoscopic procedures are minimally invasive surgeries performed through small incisions in the abdomen. A thin camera (laparoscope) and specialized instruments are used to access the pelvic structures. This technique allows for:

Precise repair of pelvic floor defects
Suspension or reinforcement of the bladder neck or urethra
Minimal tissue trauma and reduced bleeding

Transvaginal Surgery

This approach accesses the pelvic organs through the vagina, avoiding external abdominal incisions. Transvaginal procedures often involve:

Placement of supportive slings (e.g., mid-urethral slings) under the urethra
Repair of vaginal wall defects
Reinforcement of the bladder or rectum using sutures or mesh

The surgical options available to you depend on the type of urinary incontinence you have. Both laparoscopic and transvaginal surgeries are preferred over traditional open techniques because they:

Cause less postoperative pain
Lead to shorter hospital stays
Result in quicker return to daily activities
Minimize visible scarring

Most options for urinary incontinence surgery treat stress incontinence. However, low-risk surgical alternatives are available for other bladder problems, including Overactive Bladder — also called urge incontinence or urgency-frequency syndrome. Like any surgical procedure, urinary incontinence surgery comes with risks. Although uncommon, potential complications may include:

Temporary difficulty urinating and incomplete bladder emptying (urinary retention)
Development of overactive bladder, which could include urge incontinence
Urinary tract infection
Difficult or painful intercourse

Sling Procedures To Treat Stress Incontinence

Most surgical procedures to treat stress incontinence fall into two main categories: sling procedures and bladder neck suspension procedures. During a sling procedure, your surgeon uses strips of synthetic mesh, your own tissue or sometimes animal or donor tissue to create a sling or "hammock" under your urethra or bladder neck. The bladder neck is the area of thickened muscle where the bladder connects to the urethra — the tube that carries urine from the bladder. The sling supports the urethra and helps keep it closed — especially when you cough or sneeze — so that you do not leak urine. The sling procedure that's best for you depends on your individual situation.

Tension-Free Sling

No stitches are used to attach the tension-free sling, which is made from a strip of synthetic mesh tape. Instead, body tissue holds the sling in place. Eventually scar tissue forms in and around the mesh to keep it from moving. For a tension-free sling procedure, your surgeon may use one of three approaches:

Retropubic

With the Retropubic approach, your surgeon makes a small cut (incision) inside your vagina just under your urethra. Your surgeon also makes two small openings above your pubic bone just large enough for a needle to pass through. Your surgeon then uses a needle to pass the sling under the urethra and up behind the pubic bone. A few absorbable stitches close the vaginal incision, and the needle sites may be sealed with skin glue or stitches.

Transobturator

With the Transobturator approach, your surgeon makes a similar vaginal incision as in the retropubic approach and also creates a small opening on each side of your labia for the needle to pass through. The sling passes in a different pathway from the retropubic approach, but it's still placed under the urethra. Your surgeon closes the vaginal incision with absorbable stitches and the needle site with skin glue or stitches.

Single-Incision Mini

With this approach, your surgeon makes only one small incision in your vagina to perform the procedure. Through this single incision, your surgeon places the sling in a manner similar to the Retropubic and Transobturator approaches. No other incisions or needle sites are needed. Recovery time for tension-free sling surgery varies. Your doctor may recommend two to four weeks of healing before returning to activities that include heavy lifting or strenuous exercise. It may be up to six weeks before you're able to resume sexual activity. Using surgical mesh is a safe and effective way to treat stress urinary incontinence. However, complications can occur in some women, including erosion of the material, infection and pain.

Conventional Sling

With a Conventional approach, your surgeon makes an incision in your vagina and places a sling made of synthetic mesh tape — or possibly your own tissue or tissue from an animal or deceased donor — under the neck of your bladder. Through another incision in your abdomen, your surgeon pulls the sling to achieve the right amount of tension and attaches each end of the sling to pelvic tissue (fascia) or your abdominal wall using stitches. A conventional sling sometimes requires a larger incision than does a tension-free sling. You may need an overnight stay in a hospital and usually a longer recovery period. You may also need a temporary catheter after surgery while you heal.

Suspension Procedure To Treat Stress Incontinence

A Bladder Neck Suspension reinforces your urethra and bladder neck so that they will not sag and provides something for the urethra to compress against to help prevent leakage. To perform the procedure, your surgeon makes an incision in your lower abdomen. Through this incision, your surgeon places stitches (sutures) in the tissue near the bladder neck and secures the sutures to one of two places:

A ligament near your pubic bone (Burch procedure) or
Cartilage of the pubic bone (Marshall-Marchetti-Krantz procedure)

Your surgeon may recommend this surgical approach if you're also having another abdominal surgery at the same time, for instance to repair prolapse of other pelvic organs. The downside of Bladder Neck Suspension is that the procedure requires an abdominal incision, and you need general or spinal anesthesia. Recovery takes several weeks, and you may need to use a urinary catheter until you can urinate normally.

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Doctors performing Urinary Incontinence Surgery

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Our doctors are leaders in their fields, with extensive experience in advanced techniques and consistently high success rates. They work closely with our medical board and patient support team to ensure each treatment is safe, effective, and tailored to the individual.

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Testimonials

Ilanit Boker

I happily recommend the services of the GMS team. I needed a unique procedure which is not performed in Israel and I turned to them.

Over a telephone conversation with GMS representative Roy, I felt caring attention and confidence that he would help in everything. He accompanied us throughout the entire process, before the flight and even after.

In addition to Roy, we would like to sincerely thank Oriya, our allocated Israeli speaking patient coordinator of the company in Cyprus.

Even before our departure, Oriya was in touch with us helping with any issues and made sure that we arrived fully prepared – taking into account the smallest details; even to the point of finding out our food preferences, and despite the late hour of our arrival at the hotel, she ensured an exquisite meal was waiting for us in the room. Oriya greeted us upon arrival and truly made us feel like we were her personal guests. She accompanied us throughout the entire day of the operation – attentively, with endless care and continued patience.

I felt like I had a good friend with me in the hospital. This kind of treatment doesn’t happen very often… At the end of the day we parted, hugging each other, and Oriya gave recommendations on where to go and what to do in the time remaining before returning home.

I just don’t have enough words to thank GMS and Oriya for everything. I can only recommend with a reassurance that those who need it should use their services.

Almog Brand

When I was looking for information about palm surgery, I found many recommendations about Dr. Amir Oron. After a consultation with Dr. Amir, I was surprised to learn that my health insurance does not guarantee that he will be the surgeon to perform the procedure.

That is when I contacted GMS, who explained how I could have the surgery performed by the physician of my choice – which gave me peace of mind. It is very important for me to share my experience, as the service I received through GMS exceeded any similar experience in Israel: From the beginning I was assigned a GMS representative from Israel, who explained in detail what my experience would be and answered all my questions about the operation and the treatment process. (Thanks, Roy!)

All I had to do was fill out the application form. GMS representatives took care of everything themselves!

They contacted the insurance company on my behalf and even had them check the status of the application until the financial commitment for the surgery was received. We agreed with on the surgical date, booked the flights at a convenient time for me, and also dealt with the hotel reservation. The GMS staff even reviewed the menu and took any dietary restrictions into consideration on my behalf.

We were picked up from the airport in Larnaca, Cyprus where we met the wonderful Oria, who accompanied us throughout the entire visit and took care of every detail; from registration to preparation for the operation.

This is essentially a VIP service that made the entire experience relaxed and stress-free.
The assigned coordinators continued caring after my return to Israel. They were interested in my recuperation post-operatively and also ensured all financial matters were dealt with; all this, by the way, without any commissions or payouts on my part, but directly with my insurance.
In a word – an amazing experience!
In short – I recommend it!

Thank to GMS, thank you Roy, thank you Uriah and thank you Dr. Oron.

Nirit Shortz-Raphael

I do not even know where to start!!
Overall, the service exceeded all my expectations!

Roy – thank you for your patience, quick responses (minutes!), availability, caring and clear explanations! You are inimitable! Oriya – you are amazing! Thank you for every smile, hug, help, guidance, explanation… really! You are simply amazing!

Every time I was asked by friends and family about the surgery, I immediately started talking about your amazing service! I felt warmth and love, and everyone who was with me felt the same!
We never stop talking about you, and really, only good things!

You have entered our hearts!
Thank you very much for everything! I hope to see you in the future, under different circumstances.

Nadav Ben-Ezer

When one thinks of “Medical Operation” overseas, the last thing that comes to mind is a “Great Experience”, but this is exactly what I have experienced, going through a prostate removal procedure via GMS Cyprus. With their professional and compassionate approach, the GMS Cyprus team provides to the confused and worried patient a complete transparent VIP envelop, which takes care of all the logistics involved in “Medical Tourism” for the patient and their escort, as well as assembling a world class international medical team and medical facilities suitable to treat the medical diagnosis at hand.

From the first time the medical situation was diagnosed, and the first contact was made, the GMS team was there to remove the hassle and understand my concerns and worries about the medical issue and being far from home, and they handled every detail of the logistics of travel, insurance company requirements and medical preparations. From first arrival at the luxurious hotel, assigned to the first night and for my personal escort, the GMS management, Udi and Clair, has treated me as family away from home and personally came to greet me and attend firsthand to all my needs and requests. To top it all, they assigned their own personal escort, the wonderful Aia, which was available 24/7 and door to door to handle any need and detail and helped interface with the local hospital team.

I want also to recommend the choice of the hospital at Limassol, which is modern and clean, and of course GMS team have in advance reserved a private and spacious room and nominated a local doctor, which was familiar with my case and participated in the treatment and which came often to check my condition and parameters.

To summarize, I would not go so far as to wish such treatment to anybody, but if you must go through the medical procedure, the VIP treatment provided by GMS is a legitimate alternative, combining easy logistics, professional medical treatment by your own doctor, modern hospital, relaxed overseas experience and personal compassionate escorting to ease and sweeten the experience.

Dorit

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