Urinary incontinence has a reputation of being something only little old ladies have. But many young people get urinary incontinence. And while more women than men are affected, men can have urinary problems, too. Fortunately, there are many treatments for urinary incontinence.
Here is a rundown of what's available:
- 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, Gemtesa, Oxytrol, Urispas, and Vesicare) can prevent bladder spasms. Detrol, Ditropan XL, Myrbetriq, Oxytrol, 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. Vaginal weights are another option. The small weights are inserted into the vagina and your pelvic muscles contract to hold them in while you are standing. They should be used about 15 minutes a day, twice a day. A non-invasive device - pants with electrical pads - work by stimulating the muscles of the pelvic floor, and helping strengthen and re-educate the muscles that help control bladder leakage.
- Electrical Stimulation: Electrical stimulation is FDA approved for the treatment of SUI. It uses low-grade electrical current to stimulate weak or inactive pelvic muscles to contract. Regular electrical stimulation sessions can supplement or augment your pelvic muscle exercise regime. Units are available for home use and may be covered by Medicare or insurers. Another FDA approved method includes a coin-sized device called a tibial neurostimulator that can be implanted in the lower leg and to reduce symptoms.
- 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.
When Should You Seek Treatment for Urinary Incontinence?
If you have any symptoms of urinary incontinence, you should bring it up to your doctor. This is especially true if your symptoms are causing you to avoid social events, withdraw from life, or feel depressed.
Where to Go for Urinary Incontinence Treatment
For urinary incontinence treatment, start with your primary care doctor. Tell them you are having problems with bladder control. If your primary care doctor is unable to help, ask for a referral to a specialist. Doctors who specialize in treating urinary incontinence include urogynecologists, gynecologists with extra training in urinary incontinence, or urologists, doctors who specialize in problems of the urinary tract system in men and women.
How Successful Is Treatment for Urinary Incontinence?
The outlook is promising for urinary incontinence treatment. About 80% of people with urinary incontinence can improve or even be cured. The best outcome depends, of course, on getting the correct diagnosis and following your doctor's advice to help improve your condition.