For patients in South Africa

Stress incontinence surgery in Turkey from South Africa: a plain guide

Stress urinary incontinence means leaking urine when you cough, laugh, sneeze, walk, run or exercise. It usually happens because the pelvic floor muscles and the muscle that closes the urethra have been weakened or damaged. Pregnancy and vaginal birth, extra weight, family history and age all raise the chance of it, although it is not an inevitable part of getting older. This page explains when sling surgery is considered and what South African patients should plan before travelling to İzmir.

Try the simpler options first

Many women improve without an operation. Drinking less caffeine, adjusting fluid intake, stopping smoking and losing weight can reduce leaks. Pelvic floor exercises, physiotherapy, bladder training and a vaginal pessary ring are the other non-surgical options. Surgery is considered when these have been tried properly and have not been enough.

It is worth starting this with a pelvic floor physiotherapist in South Africa, so you know the simpler options have been explored before you plan a trip.

The two types of sling

• Midurethral sling: the most common operation for stress incontinence. A narrow strap of synthetic mesh is placed under the urethra and acts like a hammock, supporting the urethra and the neck of the bladder.
• Traditional sling: a strip of your own tissue, taken from the lower abdomen or thigh, is used as the sling and stitched in place through a cut in the abdomen. This avoids the risks linked to synthetic mesh, but recovery is longer and you stay in hospital for a few days.

Ask the surgeon to explain which sling is proposed for you, why, and the specific risks of mesh compared with your own tissue. You should understand the possible complications before you agree to either.

Who it suits

• Women whose leaks happen with coughing, sneezing or exercise rather than mainly with a sudden urge
• Women for whom conservative treatment has not worked
• Non-smokers, or women who can stop for two weeks before and two weeks after surgery

Complications are more common in women who are obese, who smoke, or who have lung disease or another long-term condition. Smoking raises the risk of wound healing problems, infection and bleeding, and stopping before and after surgery reduces but does not remove that risk. If you also have a feeling of bulging or heaviness, a prolapse may need treating too; see our uterine prolapse surgery guide.

Risks

Sling surgery can cause urinary problems such as urgency or difficulty passing urine, and in such cases the sling may need adjusting. As with any operation, infection and bleeding are possible.

Planning the trip from South Africa

Direct flights from Johannesburg and Cape Town to Istanbul take around ten hours, followed by a short domestic flight to İzmir. South Africans need an e-Visa before they travel, and İzmir is only one hour ahead of South Africa, which makes video follow-up easy to arrange.

Your stay depends on the sling type: a traditional sling means a few days in hospital before you can think about the flight home. Stay until the surgeon has checked that you can pass urine normally and confirms you are fit to fly. Take your operation notes home, including the type of sling used, so your GP or gynaecologist knows exactly what was done.

What we will not do

We will not suggest surgery before conservative treatment has been tried, we will not confirm a plan before a specialist has assessed you, and we will not play down the risks of mesh. South African medical schemes generally do not cover elective treatment abroad, so ask your scheme directly, and note that standard travel insurance usually excludes planned treatment abroad. Complications and clinically necessary revisions within a year are covered by our treatment guarantee; flights and accommodation remain your own responsibility. See also our women’s health guide, clinic facts, complaints page and the full sling procedure treatment page.

Frequently asked questions

Do I need surgery for stress incontinence?

Not usually as a first step. Lifestyle changes, pelvic floor exercises, physiotherapy, bladder training or a pessary are tried first. Surgery is considered when these are not enough.

What is a bladder sling?

A narrow strap placed under the urethra that supports it like a hammock. It is either synthetic mesh or a strip of your own tissue.

Can I avoid mesh?

Yes. A traditional sling uses your own tissue, which avoids mesh-related risks, but it needs a longer recovery and a few days in hospital.

What are the main risks of sling surgery?

Urinary problems such as urgency or difficulty passing urine, which may mean the sling needs adjusting, plus the usual risks of infection and bleeding.

Do I need to stop smoking before surgery?

Yes. Stop for at least two weeks before and two weeks after surgery. Smoking raises the risk of infection, bleeding and poor wound healing.

Start with a free online consultation. Planning the trip? Read the guide for South African patients and the e-Visa guide.