Urinary incontinence can severely diminish a woman’s quality of life and is a relatively common condition that can be treated.
Initial treatment typically includes Kegel exercises as the initial option, followed by anticholinergics or surgery if these don’t work. For more information on these options, consult your physician.
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Pelvic Floor Exercises
Leaks from your bladder may occur if your sphincter and pelvic floor muscles are weak, which requires you to contract them — though this may be difficult without help such as Kegel exercises. To stop it leaking, contract these muscles — although sometimes this may be hard for us individuals alone! For this reason, Kegel exercises can provide an efficient means of contractions without strain.
Kegel exercises are exercises designed to strengthen the pelvic area — or anus — through tightening and relaxing their muscles, similar to tightening and relaxing your muscle group in yoga class. When done properly, you should feel your muscles working. Doing 10 Kegels each day may improve symptoms and prevent leakage; start off slowly with five and gradually add on as your strength improves. It is usually best done lying back, although other positions including sitting, walking and exercising may work just as well.
Your doctor or a specialist can instruct you in these exercises, while an electrical stimulation device that sends mild current through your pelvic muscles and mimics Kegel exercises can also help. By sensing which muscles are contracting during this exercise, this device allows you to learn which ones need strengthening so that later you can do them on your own.
Stress urinary incontinence can cause emotional trauma as well as inconvenience and embarrassment, and lead to physical discomfort as a result of its potential leakage. Furthermore, it may interfere with relationships, work obligations and daily life activities – creating stress for all concerned involved.
Behavior treatment for SUI involves learning to anticipate activities that have caused urine loss in the past and use voluntary pelvic muscle contraction to occlude your urethra before these activities take place. This could include knowing your personal triggers such as coughing or laughing that cause an episode.
Pessary
Urinary leakage can be embarrassing and debilitating for women. Fear of leakage when participating in physical exertion such as exercising, sneezing, coughing, jumping or bending activities such as exercise can prevent women from engaging in their desired activities and even participating in sexual relations if symptoms worsen. Weight gain, depression and even anxiety disorders may result; luckily there are various treatments options for stress incontinence that can provide relief and restore your quality of life.
Pelvic muscle exercises can play an integral part in treating and preventing stress incontinence. A pelvic floor physical therapist can show you how to perform Kegel exercises to strengthen the muscles that support your bladder, urethra and other organs in the lower abdomen and pelvic region. Regular practice using proper technique is required in order to achieve results.
Internal bladder support pessaries may help alleviate urinary incontinence. These plastic rings fit comfortably around your vagina and push against your urethra to stop urine leakage, providing support that meets individual needs. They come in different shapes and sizes for your convenience.
Pessaries can be very helpful for treating SUI; however, they may not suit everyone and you should consult one of our urogynecologists or advanced practice specialists to find out which is the right treatment option for you.
Pessaries can be installed by a doctor and often feel similar to wearing a tampon when properly placed. You may experience some increase in vaginal discharge if you are post menopausal, however this is normal and will usually subside after several weeks.
Vaginal Inserts
Women experiencing urinary leakage during laughing, sneezing or coughing could benefit from vaginal inserts. These small medical-grade silicone devices, available both disposable and nondisposable varieties, help decrease SUI by exerting slight pressure against the urethra to decrease leakage. Your SLUCare doctor can determine which option will best meet your needs.
Pelvic Floor Physical Therapy, or Pelvic Retraining Exercise, can strengthen and retrain the muscles in your pelvic area to increase bladder control. When choosing a physical therapist who specializes in women’s health and has experience in pelvic muscle exercises, biofeedback training may also be offered as a form of treatment. Biofeedback helps strengthen pelvic muscles to increase effectiveness of Kegel exercises.
If these treatments fail to help, urethral bulking may be an alternative approach to consider. Under local anesthesia, this procedure entails injecting natural or synthetic materials into your urethra to build its thickness and prevent leaks when contracting pelvic muscles.
Sacral nerve stimulation is another minimally-invasive solution, performed under sedation for optimal results. Painless electrical impulses stimulate your sacral nerve to alter how your bladder responds, helping you manage any urges to pee more frequently.
SUI is an all too common condition among older adults, yet it can be effectively managed and treated. For more information about treatment for SUI, contact your SLUCare doctor or visit the American Urological Association Education and Research, Inc. website for clinical practice guidelines.
Electrical Stimulation
Urinary incontinence affects millions of people worldwide and ranges from minor leakage of urine to severe, frequent wetting. Women aged 45 or above tend to suffer more frequently, making Tufts Medical Center’s urogynecologists the go-to experts when treating stress urinary incontinence (SUI).
Stress incontinence occurs when pressure on the pelvic organs such as your bladder, urethra and vagina causes you to leak urine during activities like heavy exercise, coughing, sneezing or laughing, lifting something heavy or laughing excessively. You might experience sudden urges to urinate as well as leakage when exercising, bending over or lifting something heavy.
If you have mild to moderate SUI, symptoms may be alleviated through pelvic muscle exercises and by cutting back on behaviors that increase urine leakage such as smoking, caffeine consumption or drinking alcohol. For more severe or chronic cases of SUI, however, lifestyle modifications and other treatments can help to alleviate their condition and return you to living your life on your terms.
Your physician will conduct a physical exam and ask questions about your symptoms. He or she may recommend further tests such as urinalysis and urodynamic testing which help measure how effectively your bladder, urethra and sphincter muscles work together to store and release urine.
As well as these options, reusable incontinence pads or pantyliners may also help. These absorbent pads store urine until you can visit the bathroom; for those suffering from severe or chronic SUI, medication like duloxetine may increase muscle tone in your urethra and keep it closed; you could also try using a vaginal cone which offers support to your urethra to stop leakage during specific activities.
Surgical Options
If lifestyle changes and Kegel exercises fail to address urinary stress incontinence, your urogynecologist may suggest surgery as the most effective form of treatment – often curing most women completely of this condition. NYU Langone Center for Female Pelvic Medicine specialize in this form of surgical therapy for urinary stress incontinence cases with its range of surgical solutions available.
Surgery for stress incontinence should only be considered when other treatments have failed, or when you cannot control urine leakage while walking, exercising, lifting, coughing, sneezing or laughing. Surgery may not be right for everyone as there may be risks involved such as difficulty emptying your bladder post-procedure or complications caused by mesh tape used during surgery.
Sling surgery is the primary surgical treatment for stress incontinence. Your physician uses synthetic mesh to support the tube that carries urine (urethra). This allows the muscles in your pelvic floor to relax more evenly and avoid over-stretching which could result in leakage of urine. Your surgeon can perform the sling operation either through an open incision or multiple small incisions (laparoscopic).
Tibial nerve stimulation has proven beneficial in treating urge incontinence and overactive bladder syndrome for some individuals. A device is implanted into one buttock to administer a small electrical current through it; this helps improve how signals travel between your brain and bladder detrusor muscles, ultimately helping with overall bladder detrusor muscle control. You will require 12 sessions with each lasting 30 minutes at intervals of one week between sessions of this treatment plan.
Use of catheters can help drain urine when you cannot access the bathroom, however this increases your risk of urinary tract infections. Your doctor may advise using them only as needed and cleaning it well with antiseptic solution before every use.