How to find relief from urinary incontinence.

by Dr. Lee A. Richter, MD
May 15, 2020

Experiencing bladder leakage is common, and it can negatively impact quality of life. Thankfully, there are many treatment options available.

Urinary incontinence is the involuntary loss of urine. It affects about one in three women at some point in their lives, and becomes more likely with age. The three main types of urinary incontinence for women are:

  • Urge incontinence (overactive bladder): When you experience a loss of urine with a sudden strong desire to urinate immediately.
  • Stress incontinence: When you experience a loss of urine while performing activities that increase pressure in your abdomen, such as laughing, sneezing, or exercising.
  • Mixed incontinence: Leakage that includes symptoms of both urge and stress incontinence.

In most cases, urinary incontinence can be treated successfully. I can’t tell you how many times I’ve heard patients say, “I wish I would have seen a doctor sooner,” following their treatment. Read on to learn about common treatment options.

Urinary incontinence treatments.

There are many different treatments for urinary incontinence. This gives you the freedom to work with your doctor to determine the best option for you. In most cases, we start with conservative measures like lifestyle changes and bladder training. If they don’t alleviate your symptoms, we move on to other options, such as medications, office procedures, or surgical procedures.

First-Line Treatments

First-line treatment for all types of urinary incontinence typically involves:

  • Physical therapy.Certain exercises strengthen the muscles in and around your pelvic floor, which can help prevent leakage and calm down your urge to use the bathroom.
  • Avoiding certain foods and drinks. Beverages high in caffeine, such as coffee and energy drinks, as well as acidic and spicy foods, are known to irritate the bladder and contribute to urinary incontinence.
  • Using a pessary. You sometimes can help prevent leakage by using a pessary, a vaginal support device made of silicone.
#PhysicalTherapy can treat urinary incontinence by strengthening muscles in and around your pelvic floor. Learn about other common treatment options, via @MedStarHealth: https://bit.ly/2zLLzen.

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Make sure to speak to your doctor if you’re interested in any of these first-line treatments. To use a pessary, you’ll need to visit your doctor for a fitting and to learn how to insert, remove, and clean it. Your doctor can teach you physical therapy exercises or refer you to an expert physical therapist.

Medications

Daily medications are often a great treatment option for our patients, especially those with urge incontinence. Some of the most common medications include:

  • Anticholinergics. These help relax your bladder and reduce your leakage and urge to use the bathroom.
  • Mirabegron (Myrbetriq). This helps relax your bladder, increase the amount of urine your bladder can hold, and increase the amount of urine you’re able to urinate at one time.

Office and surgical procedures.

Surgical and nonsurgical procedures are common urinary incontinence treatments, especially for women who don’t wish to take medication. They are also the next options for women who haven’t seen the results they want with medication therapy.

Office Procedures

Common nonsurgical treatments we perform for people with urge incontinence include bladder Botox injections and nerve stimulation. Bladder Botox injections block the ability of some nerves to communicate with the bladder, reducing your leakage. Nerve stimulation is similar to acupuncture. It involves your doctor inserting thin needles into the skin to stimulate specific body points to reduce your urge incontinence.

For stress incontinence, a urethral bulking agent—which a doctor injects around the walls of your urethra using a thin needle and camera— is a great way to reduce or eliminate stress incontinence. In fact, I had one patient in her 70s who had stress incontinence that was affecting her ability to travel, as she constantly had to carry around pads to deal with her leakage. After receiving a urethral bulking agent, she reported that she no longer needs pads and can finally enjoy her vacations again.

Surgical Procedures

Urethral support surgeries are more definitive treatments for urinary incontinence. Urethral sling surgery, for example, is highly effective in treating stress incontinence. A sling acts as a hammock under the urethra to support it, and can be made of tissue from your body or a synthetic material. Make sure to speak to your doctor to learn more about surgeries that may treat your urinary incontinence.

Don’t delay care.

Urinary incontinence is a common condition, and you don’t have to manage it alone. If you’re experiencing symptoms of urinary incontinence, please reach out for help right away. If you have concerns about potential exposure to coronavirus (COVID-19) and are staying home, you can access 24/7 on-demand video access through MedStar eVisit.

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Category: Living Well     Tags: bladderhealthMedStar eVisitMedStar Healthurinary incontinenceWellness