Female Urinary Incontinence

Once you’re diagnosed with urinary incontinence, your doctor will outline treatment options that may include medication, therapies, medical devices, and surgeries. Together, you’ll determine the right treatment choice for your situation based on the severity of your symptoms and your lifestyle.

Behavioral therapies

The least invasive method of treating urinary incontinence involves making simple lifestyle changes. These changes can help you manage and reduce symptoms over time. Your doctor may recommend bladder training in which you delay urination when you feel the urge to go, with the goal of taking fewer trips to the bathroom. Scheduling urination times can also help get you on a regular schedule and lessen the chances of urine leakage between trips. Managing your diet and fluid intake can also affect your urinary incontinence—your doctor may recommend avoiding certain beverages or substances, like caffeine.

Medications

Medications can be used to lessen the symptoms of urinary incontinence by blocking signals that tell the brain to begin urinary contractions, increasing how much urine the bladder can hold, or restoring tissues in the structures that carry urine through the body. Some common medications prescribed for the treatment of urinary incontinence include:

• Anticholinergics: These drugs block the signal to the brain that causes overactive bladder contractions. Types of anticholinergics include Oxybutynin, Tolterodine Darifenacin, Solifenacin, Fesoterodine, and Trospium.
• Mirabegron and Botox: These drugs are used to relax the bladder muscles and increase the volume of urine the bladder can hold
• Estrogen: The body produces less estrogen after menopause, which can lead to a weakening of the structures that carry urine through the body. Topical estrogen can help restore these functions and lessen the symptoms of stress incontinence in menopausal women.

Medical devices and interventional therapies

In addition to medications, several medical devices and therapies can help manage symptoms of female urinary incontinence. These include:

• Pessary: A flexible plastic device inserted into the vagina to support the bladder. A pessary is most helpful for stress incontinence.
• Urethral insert: A urethral insert is inserted before activities that may lead to urine leakage, such as exercise, to prevent incontinence. It is removed before urination.
• Bulking material injections: A treatment in which a synthetic material is injected into the tissue around the urethra. Like a urethral insert, this aims to keep the urethra closed and reduce urine leakage.
• Electrical stimulation: Low-grade electrical stimulation units can be used in your doctor’s office or at home. These sessions can help stimulate weak or inactive pelvic muscles. Some devices are inserted into the vagina, while others may be implanted under the skin of the buttock.

Surgeries

If other therapies or medications are not working, your doctor may suggest surgical treatment for your urinary incontinence. Different types of surgery include:

• Bladder neck suspension: A surgery that aims to support the bladder and the area where the bladder connects with the urethra. This procedure requires general or spinal anesthesia and is performed through an incision in the abdomen.
• Sling procedure: Using a strap of synthetic material or tissue from elsewhere in the body, a surgeon creates a sling to support the urethra and keep it closed. This procedure is used to treat stress incontinence.
• Artificial urinary sphincter: Your surgeon will insert a small, fluid-filled ring around the neck of the bladder to keep the urinary sphincter shut. When you need to urinate, you will press a valve beneath your skin that will relax the ring and allow urine to flow.

Absorbent pads and catheters

For some people, urinary incontinence cannot be treated completely by medical interventions. However, there are several ways to manage and reduce the discomfort associated with urinary incontinence. Products that can lessen the inconvenience of urinary incontinence include:

• Pads and other protective garments: Absorbent pads, liners, and underwear can help catch urine leaks and allow you to go longer between trips to the bathroom. These products come in a variety of shapes and styles, and you can choose one that suits your needs and lifestyle.
• Catheters: Your doctor may recommend a catheter if your bladder is not emptying properly. A catheter is a slim, flexible tube that is inserted into the urethra several times daily to drain the bladder.