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Treatment

 

The treatment for stress incontinence will depend on how your symptoms affect your life. There are four basic types of treatment.

Behavior Changes

  • Drink less fluid if you drink more than normal amounts of fluid.
  • Do NOT hold it. Urinate when you feel the urge.
  • Avoid jumping or running or be sure to urinate before working out.
  • Take fiber to avoid constipation, which can make incontinence worse.
  • If you smoke, quit. This can reduce coughing and bladder irritation.
  • Avoid alcohol and caffeinated drinks, which can cause the urge to urinate.
  • Lose excess weight.
  • Avoid foods and drinks that may irritate your bladder, such as spicy foods, carbonated drinks, and citrus.
  • If you have diabetes, keep your blood glucose under control.

Pelvic Floor Muscle Training

  • Biofeedback is a technique that can help you learn to identify and control your pelvic floor muscles.
  • Kegel exercises can help keep the muscle around your urethra strong and working well.
  • Place a vaginal cone into the vagina and try to squeeze your pelvic floor muscles to hold the cone in place. You can wear the cone for up to 15 minutes at a time, two times a day. Symptoms may improve in four to six weeks.
  • Pelvic floor physical therapy can help strengthen pelvic floor muscles.

Pessary

  • A properly sized silicone device, similar to a tampon, is placed into the vagina. A pessary is meant to place pressure on the urethra to reduce the loss of urine with activities.
  • A pessary can be used intermittently or all day, as necessary.

Surgery
Your provider may suggest surgery if you have incontinence and other treatments have not been successful, or if your quality of life is significantly affected.

  • Vaginal slings are the most common surgery recommended. Tension-free vaginal tapes (TVTs) or obturator tapes support the bladder and urethra.
  • Bulking injections make the area around the urethra thicker to help control leakage. The procedure may need to be repeated.
  • Retropubic suspensions lift the bladder and urethra and are additional surgeries that may be recommended.