Urinary Incontinence Treatment Options

There are several urinary incontinence treatment options available to women today.

The ones most suited to you may depend upon the type of incontinence you have and its cause. Visit our page on Urinary Incontinence: Diagnosis, Causes and Types for more information on the subject.

Behavioural Remedies

Bladder Retraining

Dr G may ask you to maintain a bladder diary that records the details of your condition, including how often you to the toilet, what quantity of urine you pass, and at what times you visit the toilet (amongst others). By keeping track of these details, a pattern to your habits may become visible. This will allow you to try something called “timed voiding.” Timed voiding involves going to the toilet only at regular, scheduled intervals which avoids ‘just in case voiding’. As your control improves, you should be able to extend the period of time between each visit.

Kegel Exercises

Kegel exercises are special pelvic exercises that, if performed correctly, strengthen the muscles that help you control urine flow. To know how to perform Kegels accurately and to know what precautions to take while doing them, please visit our page on Kegel Exercises.

Weight loss

Problems with bladder control have also been attributed to being overweight, since extra weight can stress your bladder and surrounding muscles unduly. Dr G can work with you to find a suitable diet/exercise program if he thinks that your urinary incontinence is due to problems with weight.

Food and Drink

Certain food and drinks have been linked with urinary incontinence problems. While the link hasn’t been conclusively proven or explained, it might be worth your while to try abstaining from them. Alcohol, carbonated drinks, coffee, and tea are amongst the beverages linked with incontinence.

It may also help if you were to cut down on the amount of liquid you drink after dinner – and increase your fibre intake to avoid constipation (severe or chronic constipation can also cause urinary incontinence).

Smoking

Research has demonstrated that smokers are prone to incontinence. People who smoke regularly tend to have more urgent, frequent, and severe leaks than their non-smoking counterparts.

Medicines

An overactive bladder is caused by abnormal neural functioning. If you require urinary incontinence treatment as a result of an overactive bladder, Dr G may prescribe you a medicine that combats the nerve signals responsible for those frequent and sudden urges.

There are several medicines used to combat an overactive bladder. Drugs from the class ‘anticholinergics’ and ‘antimuscarinics’ work to impede bladder spasms. While the side-effect experienced most frequently is a dry mouth, problems like blurred vision, elevated heartbeat, flushing, and constipation have been known to arise with larger doses. The drugs may not be safe for you if you have glaucoma. Dr G and your ophthalmologist will be able to give you more information pertaining to your specific case.

Dr G will also ask you what medication you’re on (if any). Since some drugs can impact the muscles and nerves of the urinary system, you may find that an alternate prescription can help eliminate your urinary incontinence problems. Pills that treat edema and blood pressure, for example, have been found to cause problems with bladder control.

Urinary Incontinence Treatment Methods

Biofeedback

Biofeedback is a urinary incontinence treatment method that uses electronic measuring devices to familiarise you with the functioning of your body. These devices can help you track bladder and urethral contractions, allowing you to control them. Together with pelvic floor exercises and electrical stimulation, biofeedback can help treat both stress incontinence and urge incontinence.

Vaginal Pessary

If you suffer from mild stress incontinence or if you’re not a suitable candidate for surgery, Dr G might recommend using a pessary as a treatment option. Stress incontinence is often caused by weakened pelvic muscles. A pessary is a stiff ring-shaped device that Dr G will place inside you to reposition the urethra. Since pessaries can increase your chances of developing an infection, Dr G will explain what precautions you need to take and schedule a follow-up consultation if necessary.

Injections for Stress Urinary Incontinence

Stress incontinence can also be treated through injections. Bulking agents like collagen can be injected into you to make the tissue surrounding the neck of your bladder thicker. This can help close the opening of the bladder, thus reducing stress incontinence. You may have to take a skin test, first, to make sure that you aren’t allergic to the material. Since there’s a possibility that your body will eliminate these agents over a period of time, you may have to take the injection more than once.

Botox Injections for Urge Urinary Incontinence

Urge incontinence can also be treated through Botox injections, especially in cases where medications and other treatment methods do not work. With the help of a cystoscope, small doses of Botox will be injected into your bladder muscle. Botox helps reduce bladder spasms, which in turn may reduce your incontinence and the need to visit the toilet frequently. You will be taught ‘self catherization’ in case you have difficulty emptying your bladder. You may be required to take the injection more than once since your body may eliminate these agents with time.

Surgery for Stress Urinary Incontinence

This option has a high success rate and is considered the mainstay and gold standard treatment for stress incontinence.

The technique is minimally invasive and uses mid-urethral slings (retropubic or transobturator). The process involves the placement of a synthetic mesh midway along the urethra. As a part of the procedure, Dr G will make small incisions behind the pubic bone or just by the sides of the vaginal opening, as well as a small incision in the vagina. With specially designed needles to position a synthetic tape under the urethra. Dr G will pull the ends of the tape through the incisions. He will then adjust them so that they provide the urethra with the right amount of support. This method causes negligible discomfort and allows you to near-normal functioning very soon. You will either be discharged on the same day that the procedure is performed or the next.

If you also happen to have a pelvic prolapse, Dr G may recommend an anti-incontinence procedure with a prolapse repair and, if necessary, a hysterectomy.