Behavioral treatment. Some people with urinary incontinence may get relief by making simple lifestyle changes. If you have stress incontinence, for instance, in which you leak urine when you cough, sneeze, or laugh, your doctor may tell you to limit how much you drink. If you have urge incontinence, in which you get the sudden urge to urinate and can't always make it to the bathroom in time, your doctor may tell you to avoid spicy foods, caffeine, and carbonated drinks, because they can irritate the bladder and make the problem worse. Exercises to strengthen the pelvic floor muscles, known as Kegels, can sometimes help people with stress incontinence. Kegels can also help people with urge incontinence. Sometimes, Kegels are combined with biofeedback techniques to help you know if you are doing the exercises properly. For urge incontinence, bladder training, sometimes called bladder retraining, can also help. This involves gradually increasing the interval time between trips to the bathroom, working up to longer and longer intervals between bathroom stops.
Drugs. For urge incontinence, medications known as anticholinergics/antimuscarinics (Detrol, Ditropan XL, Enablex, Oxytrol, Urispas, and Vesicare) can prevent bladder spasms. Oxytrol, Detrol, Ditropan XL, Myrbetriq, and Vesicare also are approved for women with overactive bladder (OAB). Oxytrol is available without a prescription. OAB is a condition in which the bladder squeezes too often or without warning, resulting in incontinence. Also, Botox injected into the bladder muscle causes the bladder to relax, increasing its storage capacity and reducing episodes of urinary incontinence. It can be used for adults who do not respond to or can't use the medications listed above.
Devices and absorbent products. Protective pads and panty liners can help avoid embarrassing situations. A pessary, a plastic device inserted into the vagina, may help prevent urine leakage by supporting the neck of the bladder; it is most useful for stress incontinence.
Surgery. If the above treatments don't provide enough relief, surgery may help. One procedure works by supporting the bladder so that it returns to its normal position. Another surgery, called a sling procedure, uses a strap of synthetic mesh or natural tissue to support the urethra, the tube that carries urine. There are also small nerve stimulators that can be implanted just beneath the skin. The nerves they stimulate control the pelvic floor area and the devices can manipulate contractions in the organs and muscles within the pelvic floor.