Incontinence Therapies
Incontinence therapies include behavioral modification, Kegel exercises, and change in urination habits. Additional treatments include:
Pessaries
Incontinence pessaries are plastic devices, similar to vaginal contraceptive diaphragms, which are used to either lift the bladder or to apply some compression to the urethra during activities that are known to cause leakage. They are successfully used for the treatment of stress urinary incontinence and vaginal or uterine prolapse. They are a low risk treatment option when compared to surgery for symptomatic urinary incontinence. About half of the women who are successfully fitted with a pessary will continue to use it on a long-term basis.
Back to top
Medications
A number of medications are available that increase sphincter or pelvic muscle strength or relax the bladder, making it able to hold more urine. Medications are prescribed for all kinds of incontinence, but they are generally most helpful for urge incontinence.
Back to top
Pelvic Muscle Strengthening
The aim of Kegel exercises is to fortify muscle tone by strengthening the pubococcygeus muscles of the pelvic floor. Factors such as pregnancy, childbirth, aging, being overweight, and abdominal surgery such as cesarean section, often result in the weakening of the pelvic muscles. Though most commonly used by women, men can also use Kegel exercises. The objective of this is similar to that of the exercise in women with weakened pelvic floor: to increase bladder and bowel control.
Back to top
Surgery
Surgery including pelvic floor reconstruction, bladder neck suspension or sling procedures, and implantation of an artificial urinary sphincter or sacral nerve stimulator. Urinary incontinence surgery is usually considered only if more-conservative strategies aren’t helping. Urinary incontinence surgery is more invasive and has a higher risk of complications than do other therapies, but it can also provide a long-term solution in severe cases. Most options for urinary incontinence surgery are used to treat stress incontinence. However low-risk surgical alternatives are also available for other bladder problems, including severe urge incontinence, which is also called overactive bladder and non–obstructive urinary retention.
Back to top
Timed Voiding
Timed voiding means that the bladder is emptied on a regular basis —not only when the urge to void is felt. Timed voiding prevents the bladder from overfilling and sending urgent messages to empty. Timed voiding allows persons with urge incontinence to have some control over their bladder, instead of their bladder being in control of them. It’s also helpful in situations where the impulse to empty isn’t received, as with individuals with a neurological impairment or in some cases of dementia.
Back to top
Vaginal Cones
Vaginal cones can be used to help women to train their pubococcygeus (or PC) muscles. Cones are inserted into the vagina and the pelvic floor is contracted to prevent them slipping out. Vaginal cones are recommended for women who have developed bladder incontinence or an overactive bladder. This technique is designed to help the pelvis floor muscle become firmer, thicker and broader, and helps to hold the bladder in the correct place, especially when standing in an upright position
Back to top
