How Is Stress Incontinence Treated? continued...
Weight loss: Stress incontinence has been linked to obesity.
Timed voiding: Record the times that you urinate and when you leak urine. This will give you an idea of your leakage "patterns" so that you can avoid leaking in the future by going to the bathroom at those times.
Bladder training: In bladder training, you "stretch out" the intervals at which you go to the bathroom by waiting a little longer before you go. For instance, to start, you can plan to go to the bathroom once an hour. You follow this pattern for a period of time. Then you change the schedule to going to the bathroom every 90 minutes. Eventually you change it to every two hours and continue to lengthen the time until you are up to three or four hours between bathroom visits.
Another method is to try to postpone a visit to the bathroom for 15 minutes with the first urge. Do this for two weeks and then increase the amount of time to 30 minutes and so on.
Device: The doctor can insert a device called a pessary into the vagina to stop stress incontinence. A pessary is a ring that, when inserted, puts pressure on the urethra in order to keep it in its normal location. Doing so can reduce urine leakage. Possible side effects from using a pessary include vaginal discharge and infections.
Injections: Bulking agents are substances that are injected into the lining of the urethra. They increase the size of the urethra lining. Increasing the size creates resistance against the flow of urine. Collagen is one bulking agent that is commonly used. If successful, periodic injections may be needed.
Surgery: When other methods for treating stress incontinence don't work, surgery may be an option. Surgery is now minimally invasive and performed on an outpatient basis in most cases. There are three types of surgery designed to help keep the bladder in place and treat stress incontinence:
- Retropubic suspension: In this procedure, the surgeon makes an incision in the abdomen. The surgeon then attaches the neck of the bladder to the pubic bone with sutures.
- Sling procedure: In this procedure, the surgeon uses a sling made of either natural (human) tissue or synthetic material. The sling goes around the bladder neck and is attached to the pubic bone.
- Artificial sphincters: Most frequently used for men but also may be appropriate for women. A fluid-filled cuff is implanted around the urethra that can be opened and closed by the patient and that serves as a valve to contain the bladder content that might otherwise leak.
These surgeries can effectively treat the vast majority of stress incontinence cases. Side effects of surgery include continued or worsened incontinence or an inability to urinate.