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Relief for u​rinary incontinence

Incontinence is the inability to control the passage of urine and can range from an occasional leakage of urine to a complete inability to hold any urine. There are several different types of urinary incontinence. It is most common among the elderly, and women are more likely to experience incontinence than men.

The main types of urinary incontinence include:

  • Stress incontinence happens during certain activities, like coughing, sneezing, laughing or exercise.
  • Urge incontinence involves a strong, sudden need to urinate followed by instant bladder contraction and involuntary loss of urine. You don't have enough time between when you recognize the need to urinate and when you actually do urinate.
  • Mixed incontinence contains components of both stress and urge incontinence.
  • Overflow incontinence happens when you experience frequent or constant dribbling of urine due to a bladder that doesn't empty completely.
  • Functional incontinence is when a physical or mental impairment keeps you from making it to the toilet in time. For example, if you have severe arthritis, you may not be able to unbutton your pants quickly enough to get to the bathroom.
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Diagnosing your condition

You may feel uncomfortable discussing urinary incontinence with your doctor, but if incontinence is frequent or affects your quality of life, it's essential to seek medical advice. Urinary incontinence may:

  • Cause you to restrict your activities and limit your social interactions
  • Negatively impact your quality of life
  • Increase the risk of falls in older adults as they rush to the toilet
  • Indicate a more serious underlying condition

Your physician will review your medical history and symptoms and ask various questions about what you are experiencing. You may have a physical exam where your doctor examines your pelvic floor muscles and evaluates your ability to control them. The physical exam may also include a rectal or vaginal examination to help determine the proper urinary incontinence treatment.

Your physician may choose to run other evaluations, including urodynamic tests to determine how well certain muscles work together or a cystoscopy to examine the lining of the bladder and urethra.

A woman in a blue shirt and jeans sits on a chair while discussing her urinary incontinence with a doctor

Non-surgical urinary incontinence treatments

For many, surgery isn't required to treat urinary incontinence successfully.

  • Behavioral Methods
  • Injections
  • Lifestyle Modification
  • Medication
  • Pelvic Floor Therapy
  • Support Devices

Behavioral Methods

One type of urinary incontinence treatment involves behavioral methods. Techniques including bladder training, timed urination, pelvic floor exercises and relaxation techniques, like meditation and warm baths, can all contribute to better control of pelvic floor muscles.

Injections

Botox can treat an overactive bladder, and calcium can treat urinary incontinence by narrowing the urethra.

Lifestyle Modification

Weight loss and dietary changes—such as reducing caffeine consumption and increasing the amount of water you drink—and adopting a regular exercise routine that includes targeted pelvic muscle exercises can lead to better pelvic health and lessen the impact and longevity of pelvic floor disorders, which may cause urinary incontinence.

Medication

Certain oral medications, including anti-diarrheal medications, muscle relaxants and other prescription drugs, can help alleviate symptoms of urinary incontinence.

Pelvic Floor Therapy

Pelvic floor therapy effectively corrects weak muscles and joint alignment problems that often cause pelvic floor disorders. It can help alleviate the pain, pressure and discomfort associated with urinary incontinence.

Physical therapists will introduce exercise and therapy to help strengthen weak pelvic floor muscles, decrease urinary frequency and allow better control over urinary and bowel functions.

Support Devices

Devices, such as a vaginal pessary, can help keep pelvic organs in place when prolapse occurrs, and they can also help women with stress urinary incontinence.

A pessary is inserted into the vagina to help support the uterus, vagina, bladder or rectum as a type of urinary incontinence treatment.

Surgical treatment options for urinary incon​​​​tinence

 

Surgery is typically reserved for when non-surgical techniques have not improved your condition

When recommending surgery as an option to treat urinary incontinence, your doctor will consider your medical history, personal preferences and general health. In many cases, less-invasive surgical options are available, such as laparoscopic or robotic surgery, which often support faster recoveries.

Surgical options to treat urinary incontinence include:
  • Transvaginal sling: Strips of synthetic mesh or your own tissue are surgically inserted to create a sling under the urethra or under the muscle where the bladder connects to the urethra. The sling helps to support the urethra and keep it closed to prevent urine leakage.
  • Sacral neuromodulation: This surgically implanted device treats overactive bladder and urinary incontinence. A neurostimulator is inserted just above the waistline that sends electrical pulses to an electrode inserted in the lower back, which controls the bladder and bowel control nerve.
  • Vesicovaginal fistula removal: A vesicovaginal fistula is an abnormal connection between the bladder and the vagina that allows urine to leak. With this kind of urinary incontinence treatment, the surgeon removes the fistula and closes the opening.
  • Strengthen pelvic floor muscles to combat pain and incontinence

    Pelvic floor muscle weakness and tension contribute to pelvic pain and incontinence. Postural and joint alignment problems can prevent your muscles from working optimally for you. Pelvic floor therapy may be right for you.

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