by Carmack A

There are many ways to treat urinary incontinence. This may include one or all of the following:

Behavioral Therapy

Bladder retraining is often the first way to treat incontinence. You need to have some control over your bladder for this to work. You also need to know when leaks happen. If you tend to leak urine 3 hours after passing it, you could go to the bathroom every 2½ hours. Slowly, you can make the time longer between trips to the bathroom.

Exercises

Not all the muscles involved with bladder control are automatic. You have control over the sphincter that holds urine in. You make it stronger by doing Kegel exercises:

  • Tighten the muscles in your bottom as if you were holding in urine or stool. These muscles contract together.
  • Hold them as tight as you can for a slow count of 10.
  • Relax.
  • Repeat 10 times each session, and to them many times a day.

Some people find help by using a physical therapist who knows how to train pelvic floor muscles.

Ask your doctor about weighted vaginal cones. These are designed to the make pelvic floor stronger.

Devices

Pessaries are placed into the vagina. Most are designed to make the bladder sphincter work better by supporting the bladder floor.

Catheterization

Draining the bladder at regular times with a catheter keeps it from spilling uncontrollably. People who have a neurogenic bladder can learn how to do this by themselves. If that can't be done, you may need a catheter that stays in all the time.

Your doctor will teach you how to care for the catheter. You will also learn how to look for signs of infection. Using a catheter makes this risk higher.

Nerve Stimulation

Devices can be used to excite certain nerves. A thin lead wire with a small electrode tip is implanted. In some cases, the tibial nerve, which runs down to the ankle, is stimulated. This may need to be done more than once, but it can be in a doctor's office.

Biofeedback

By using electrical sensors, the squeezing of the sphincter muscle can be seen or heard. While attached, you are encouraged to make the signal higher. This will make the involved muscle stronger. This form of treatment has not yet become widely accepted.

References

Behavioral interventions for urinary incontinence. EBSCO DynaMed Plus website. Available at:  http://www.dynamed.com/topics/dmp~AN~T900645/Behavioral-interventions-for-urinary-incontinence . Updated August 28, 2018. Accessed January 18, 2019.

Occhino J, Siegel S. Sacral nerve modulation in overactive bladder. Curr Urol Rep. 2010;11(5):348-352.

Treatments for bladder control problems (urinary incontinence). National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: https://www.niddk.nih.gov/health-information/urologic-diseases/bladder-control-problems/treatment. Updated June 2018. Accessed January 18, 2019.

Urinary incontinence. Urology Care Foundation website. Available at: http://www.urologyhealth.org/urologic-conditions/urinary-incontinence. Accessed January 18, 2019.

Urinary incontinence in adults. Merck Manual Professional Version website. Available at: https://www.merckmanuals.com/professional/genitourinary-disorders/voiding-disorders/urinary-incontinence-in-adults. Updated July 2018. Accessed January 18, 2019.

Urinary incontinence in women. EBSCO DynaMed Plus website. Available at:  http://www.dynamed.com/topics/dmp~AN~T900573/Urinary-incontinence-in-women . Accessed November 14, 2018. Accessed January 18, 2019.

Revision Information

  • Reviewer: EBSCO Medical Review Board Adrienne Carmack, MD
  • Review Date: 12/2018
  • Update Date: 01/18/2019