Tackling incontinence through life-changing procedures

In South Africa, one in three women suffers from urinary incontinence, 

and yet access to timely treatment remains limited, particularly in the public healthcare system, where backlogs for intervention can extend to a year.

According to Dr Colin Montgomery, Urogynaecologist at Mediclinic Stellenbosch, these delays carry consequences far beyond just physical discomfort. “Delayed treatment often results in worsening symptoms, which can lead to infections, morbidity and even mortality in vulnerable patients,” he says. “But the emotional and social toll is often just as significant.

“There is a strong sense of embarrassment and loss of dignity, with many women feeling ashamed or anxious about odour or visible leakage. Some avoid exercise, travel, and social interaction, and may struggle to maintain employment – especially in roles without easy access to restrooms. There are also hidden economic costs, including spending on pads, extra laundry, and lost productivity,” he adds.

Defined as the involuntary leakage of urine, urinary incontinence presents in several forms, including stress incontinence, urge incontinence, and overflow incontinence. Despite how common it is, Dr Colin Montgomery says urinary incontinence is frequently underreported and undertreated, even though there are effective ways to manage and treat the condition.

“Many women suffer in silence, either too embarrassed to seek help or unable to get access to effective treatments,” he says. “But timely intervention can be truly life-changing for women who have been living with untreated urinary incontinence, especially those discouraged by long waiting lists.”

In response, Mediclinic is marking World Continence Week (15 to 21 June) with a targeted corporate social investment (CSI) initiative aimed at reducing the treatment backlog. The initiative will see eight public sector patients, referred from Groote Schuur Hospital, undergo intravesical Botox procedures to treat urge incontinence next week Monday, 15 June 2026. This is in addition to the over 1,600 pro-bono surgeries Mediclinic has performed since 2018.

Dr Montgomery, who spearheaded the initiative, says the decision was driven by both clinical need and a desire to make a tangible difference. “With increasing service pressures, cancelled theatre lists, and limited resources, the waiting list continues to grow. This is a way to contribute, even in a small way, to restoring quality of life for women who have been waiting too long for care.”

Intravesical Botox is a minimally invasive procedure that involves injecting botulinum toxin into the bladder wall. This works by relaxing the overactive bladder muscles responsible for urgency and involuntary contractions. The procedure is typically performed under sedation in a day-theatre setting and can be completed within an hour.

“Early treatment can significantly improve or even resolve symptoms, allowing women to regain bladder control and return to normal daily activities,” explains Dr Montgomery. “It can also reverse many of the emotional and social effects, restoring confidence and independence.”

Dr Montgomery notes that there are also non-medical methods that can be very effective in some cases, especially when they are started early. “Many women can see significant improvement with conservative measures,” he says, encouraging first-line treatments such as pelvic floor muscle training, bladder training, and lifestyle adjustments, including weight management, and reducing caffeine and alcohol intake.

“Awareness and education are also absolutely critical,” he adds. “In my experience, one of the biggest barriers is not just access to care, but the fact that many women don’t realise that what they are experiencing is a medical condition that can be treated.”

Dr Montgomery says his message to women is simple: “You are not alone, and you do not have to live with this. There are effective treatments available and taking that first step to seek help can be life changing. The sooner you come forward, the sooner we can help you regain your confidence, comfort, and quality of life,” he concludes.