Africa. In South Africa, one in three women suffer from urinary incontinence, but access to timely treatment is limited, especially in the public health system, where the delay in intervention can be up to a year.
Disregarding attitude
These delays have consequences beyond physical discomfort. Delayed treatment often results in worsening symptoms, which can lead to infections, morbidity and even death in vulnerable patients, but the emotional and social toll is often just as significant.
There is a strong sense of embarrassment and loss of dignity that many women feel ashamed or distressed by smelly or visible discharge. Some avoid exercise, travel and social interaction and may struggle to hold down a job – particularly in roles without easy access to toilets. There are also hidden economic costs, including costs for coatings, extra laundry and lost productivity.
What exactly is it?
Urinary incontinence is defined as the involuntary leakage of urine, which comes in several forms, including stress incontinence, stress incontinence, and incontinence. Despite how common it is, urinary incontinence is often underreported and untreated, even though there are effective ways to manage and treat the condition.
Many women suffer in silence, or are too embarrassed to seek help or unable to access effective treatments, but early intervention can really change the lives of women living with urinary incontinence, especially those frustrated by long waiting lists.
Treatment of neglect
In response, Mediclinic marked the World Continence Week (June 15 to 21) with a targeted Corporate Social Investment (CSI) initiative aimed at reducing treatment backlogs. The initiative saw eight public sector patients referred from Groote Schuur Hospital undergo internal Botox procedures to treat severe impotence from 15 June 2026. This is in addition to the more than 1,600 pro-bono surgeries that Mediclinic has performed since 2018.
I spearheaded the initiative, and the decision was driven by both clinical need and the desire to make a significant difference. With increased service pressure, theater cancellations and limited resources, waiting lists continue to grow. It is a way to help, even in a small way, to restore the quality of life of women who have waited too long for care.
Disregard order
Intravesical Botox is a minimally invasive procedure that involves injecting botulinum toxin into the bladder wall. It works by relaxing the overactive bladder muscles responsible for sudden, involuntary contractions. The procedure is usually performed under sedation in a day theater environment and can be completed within an hour.
Early treatment can significantly improve or even eliminate symptoms, allowing women to regain bladder control and return to normal daily activities. It can also reverse many emotional and social effects, restore confidence and independence.
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, encouraging first-line treatments such as pelvic floor muscle training, bladder training, and lifestyle modifications, including weight management and caffeine reduction, and alcohol consumption.
Awareness and education are also absolutely essential. In my experience, one of the biggest barriers is not only access to care, but also the fact that many women do not realize that what they are experiencing is a medical condition that can be treated.
Bottom line
My message to women is simple. You are not alone and you don’t have to live with this. Effective treatments are available, and taking that first step to seek help can be life-changing. The sooner you move forward, the sooner we can help you regain your confidence, comfort and quality of life.
Who is the author?
Dr. Colin Montgomery is an obstetrician and gynecologist with a subspecialty in urogynecology, specializing in Stellenbosch Medical. Her clinical interests are in women’s health and pelvic disorders, including urinary and fecal incontinence, overactive bladder, pelvic organ prolapse, and related bladder and bowel disorders.
She offers comprehensive individualized care that may include urodynamic evaluation, pelvic floor reconstruction, and minimally invasive surgical options (including advanced laparoscopic and robotic techniques) when necessary, along with general gynecological services such as routine screening, menstrual concerns, family planning, and early pregnancy care (up to 23 weeks).
