Do you chuckle or bristle at the TV ad where two jolly women joke about their “big pee pants” in the yoga class?Or, along with your mother, sister or friends, do you cringe, perhaps in the belief that living with urinary leaking is something inevitable?Far from serving women’s wellbeing, these comedy TV vignettes only serve to reinforce the message that stress, or urge, urinary incontinence (SUI) is normal. They make a mockery of the sheer misery, frustration and actual disempowerment suffered by women with SUI. Like a dark shadow lurking alongside her, armed with her costly, daily supply of nappies or pads, once she leaves home, her only basic cover is to wear black trousers, or skirt while she heads out.Ireland is the only EU country not to offer the TVT mesh to women suffering from this debilitating and distressing condition. In fact, along with New Zealand, Ireland is the only country not to offer this treatment to women. According to the Continence Foundation of Ireland, about 350,000 people are affected by some form of incontinence – one in four women, and one in 10 men.“There’s nothing normal about urinary incontinence,” says Dr Suzanne O’Sullivan, gynae-obstetrician at Cork University Maternity Hospital .There are two types of UI: stress incontinence, which is the involuntary leakage of urine due to physical pressure (coughing, laughing, exercise and so on) caused by weak pelvic floor muscles. Urge incontinence is often down to an overactive bladder, which is chartered by a sudden, intense need to pee followed by immediate spill.Marathon runner from Co Cork, Liz Lenehan, was diagnosed with breast cancer in 2021. “To be honest, the symptoms I experience every day from UI are more stressful than I ever went through with my cancer treatment,” says the 52-year-old.“After the birth of my third child, I was trying to lose baby weight and joined a running club. I really loved it, but noticed that I was leaking every time I ran. But the UI was getting worse and worse. I was wearing pads while I was running, but my leggings would still be wet at the end of the run. And this led me to getting blisters on my labia from the wet.”[ Urinary incontinence: ‘Many a field I went into and many a stinging I got’Opens in new window ]The four treatment options include: the bulking agent; colpo suspension; autologous fascia pubovaginal slings; and mesh surgery.In 2018 concerns were raised in the UK about the use of the trans-vaginal mesh procedure for pelvic organ prolapse. The HSE imposed a blanket “pause” on all urogynaecological procedures using the polypropylene mesh, which is still in place eight years on. The mesh-sling had been available to women in Ireland who suffered with stress or urge urinary incontinence for the preceding 20 years.At the time, the Department of Health said “this pause should remain in place until the HSE confirms implementation of recommendations relating to surgical training, informed consent and the development of an agreed data set of mesh procedures.Lisa Watson says she is “one of thousands of women who have been deprived of the surgery that we so badly need. We go to our doctors, and then to a urogynaecologist, to get the best advice on what options are available. We then decide what’s best for us. But since 2018 we have the Government deciding what best for women’s bodies.“They don’t know what a day of my life looks like. I have two kids, and two jobs. I’m 43 years of age, and am 10 years into this incontinence journey. When I wake in the morning, I don’t get from the top of my bed to the bottom of my bed without gushing. It’s not a bit of a leak, which is what people think. I wet myself every morning and continue my day, while managing my UI in the background.“What I want to say is that I need the mesh surgery – but I’m not leaving this country to have it done. Why should I, when we have all the medical expertise ready, willing and able to do the surgeries here in Ireland?”The percentage of women who consider themselves fixed after surgery is 92 per cent— Dr Suzanne O’SullivanGynae-obstetrician Prof Barry O’Sullivan, of Cork University Maternity Hospital, says “much of this controversy kicked off in the US, where the procedure was widely available, and had become lucrative. Whilst every medical procedure carries risk, this boiled down to a case of the wrong doctor, with the wrong patient, and the wrong operation, in the wrong hands. In some cases, the procedure was being carried out by unsuitably qualified specialists, which is what led to complications for the patient. This is an enormous quality-of-life issue and the TVT is a very good solution.”The burning question here is: Why is the HSE funding a procedure abroad that it does not permit in Ireland?Since 2021, under the Treatment Abroad Scheme (TAS) – through the medical tourism agency Healthcare Abroad – we know that, from December 2025 to May 2026, at €29,000 per person, under theCross-Border Directive, 29 women have travelled to Spain and the Netherlands to undergo the 30-minute procedure. Some patients are self-funded, while others are covered by their own health insurance.The €29,000 figure includes the cost of the mesh procedure (€7,900), the pre-, and often multiple post-procedure consultations, flights and accommodation.Dr Suzanne O’Sullivan describes this expenditure as “a totally irresponsible waste of public funds. The TVT procedure is well-established over 25 years now, and is considered the gold standard, with a low complication rate and high success rates. Women have been travelling to the EU to have this procedure since 2021.“I was performing this surgery all the time, right up to the temporary pause was implemented. Like my colleagues, I’m still being paid to perform this surgery – except that we’re not allowed to do it, which means that we are paying on the double for the procedures. We can only advise, and counsel the sufferer to either wait or travel abroad for the TVT. I’d like to emphasise that the percentage of women who consider themselves fixed after surgery is 92 per cent.”[ Tips for dealing with incontinenceOpens in new window ]In October 2023, the National Vaginal Mesh Implant Oversight Group submitted the report that had been requested by the HSE in 2020. It addressed the 19 requirements raised, relating to the use of mesh in urogynaecological procedures. However, the wait continues. For as long as they continue with their considerations, women stay wet. And this comes at an high cost in mental health, weight gain, occupational health and quality of life.“We want equal access for Irish women to all surgical options for their SUI,” says Dr O’Sullivan. “The [HSE’s own] national guidelines are that all women needing surgery should be offered all surgical options, with full counselling and assisted decision-making tools. This way women can make up their own mind and be allowed to choose the option most suited to them.”Women are being referred to consultants on the Continent, such as Prof Jean Paul Roovers, who has already treated at least 60 Irish women at his clinic in Amsterdam since 2021. Every six weeks, at the Vithas Medimar private hospital, outside his contracted hospital working hours in Ireland, Prof O’Reilly travels to Alicante to perform the TVT procedure on Irish patients.“I don’t think the Government should have the right to tell me what I can and cannot do with my body,” says Liz Lenehan. “I want my life back, and the right to be able to run again. I also don’t want to have to leave the country to get this surgery.“I don’t see why I should have to travel to get it? For me, this feels like we’re looking at the abortion debate all over again – where women leaving the country and coming home on flights after having surgery.”