Institute of Urology
The Institute of Urology is part of the Department of Surgery, where experienced surgeons provide advanced treatment options, research programs, and education and training opportunities.
Treatments for Urinary Incontinence
Personalized treatment options to help improve bladder control
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Treatments for Urinary Incontinence That Fit Your Needs
At Lahey Clinic, care begins with a clear understanding of your symptoms and goals. The Continence Center offers a wide range of treatments for urinary incontinence, from lifestyle strategies to advanced procedures.
Treatment plans may involve urology and urogynecology specialists. Care is designed to start with the least invasive options and move to more specialized treatments if needed.
Bladder Care and Lifestyle Changes
Bladder care for incontinence often begins with simple steps that can make a meaningful difference. These approaches are commonly the first part of treatment.
Lifestyle and behavioral strategies may include:
- Fluid and diet changes
- Timed voiding and bladder training
- Weight management
- Managing constipation
- Reducing bladder irritants such as caffeine, alcohol, and carbonated beverages
These changes support long-term bladder health and may reduce symptoms over time.
Pelvic Floor Therapy and Exercises
Exercises for incontinence help strengthen the muscles that support the bladder and urethra. Pelvic floor muscle training can improve control and reduce leakage.
Treatment may include:
- Pelvic floor strengthening exercises
- Biofeedback therapy
- Bladder retraining programs
These therapies are often recommended as a first step or combined with other treatments.
Incontinence Products and Devices
Incontinence products and devices can help manage symptoms and improve daily comfort.
Options may include:
- Absorbent pads and protective garments
- Catheters for bladder emptying (intermittent self-catheterization and indwelling catheterization)
- Vaginal inserts and urethral devices (such as a pessary)
Incontinence Medications
Incontinence medications may help control bladder activity and reduce urgency and frequency. Incontinence medicine is often used alongside lifestyle changes and pelvic floor therapy. Medications support incontinence specifically by relaxing the bladder muscle, reducing spasms and improving the bladder's ability to store urine. Your care team will review the benefits and possible side effects to find the best option for you.
Advanced Procedures and Surgery for Incontinence
If symptoms continue despite conservative treatment, more advanced options may be recommended.
Minimally invasive procedures may include:
- Bladder injections to calm overactive bladder muscles
- Nerve stimulation therapies that improve bladder signaling
Surgery for incontinence may be recommended for some individuals. Surgical options are tailored to the type and cause of incontinence and focus on improving bladder support and function.
Treatments for Conditions Affecting Continence
Urologists at Lahey’s Continence Center are highly experienced in performing innovative procedures to treat conditions that affect continence. Here are some examples.
For pelvic organ prolapse:
- Vaginal repair (non-mesh-based)
- Sacrocolpopexy (open or robotic-assisted)
For vesicovaginal fistula:
- Vaginal corrective repair
- Abdominal corrective repair
For interstitial cystitis:
- Diagnostic cystoscopy and hydrodistension
- Guidance for bladder instillation protocols
Surgical Treatments for Urinary Incontinence
Vaginal Sling Surgery
The purpose of this procedure is to create a “hammock” to support the urethra and prevent it from opening when you cough, sneeze or laugh. This procedure is minimally invasive and performed in an outpatient setting. At Lahey’s Continence Center, we have achieved excellent results with this pubovaginal sling.
Urethral Bulking Agent Injections
Bulking substances, which are specially formulated artificial materials, may be injected in the urethra to provide bulk and support in order to reduce the effects of stress urinary incontinence. The injection procedures are performed in the office setting under local anesthesia.
Sacral Neuromodulation
This procedure involves implanting an electrical stimulator into the body that sends impulses to the sacral nerve, which controls the bladder. This helps target the communication problem between the brain and the nerves that control the bladder.
Tibial Nerve Stimulation
In this procedure, similar to sacral neuromodulation, electrical stimulation is delivered to the tibial nerve and travels to the sacral nerve, which controls the bladder.
Botox Injections
OnabotulinumtoxinA (Botox) is an FDA-approved therapy for certain patients with overactive bladder. Botox is injected into the bladder muscle through the urethra either in the office or under conscious sedation in the operating room.
Bladder Enlargement (augmentation cystoplasty)
This is a reconstruction procedure to reduce the bladder’s internal pressures and increase its capacity. It is performed for patients whose incontinence has resulted from conditions such as spina bifida, spinal cord injury, multiple sclerosis, radiation cystitis or congenital (inherited) conditions.
