How is urge incontinence treated?

Urge incontinence is typically a medically managed condition. Watch as Justin Parkinson, MD, an urologist at Lakeview Hospital discuss the two FDA-approved devices used in managing urge incontinence.
Pelvic floor exercises help people with urge incontinence. Reprogramming the pelvic muscles and their response to bladder contractions is well supported by scientific evidence, making these exercises the primary therapy to help suppress urge incontinence episodes, urinary urgency and frequency. In select patients, pelvic floor stimulation and tibial nerve stimulation have proven effective, according to research published by the National Institutes of Health. Stimulation involves sending electrical currents through the skin along the nerve path using the pelvic floor or the back of the ankle as stimulation sites. 
If those treatments don’t work, however, doctors may prescribe medications, known collectively as anticholinergics, that target the variety of receptors that carry the signals for bladder relaxation and contractions. The goal is to reduce the urgency to urinate, as well as the episodes of incontinence. While studies point to their effectiveness in treating urge incontinence, most of these medications carry a risk for side effects, including constipation and dry mouth.  Treatment should be monitored by a doctor, the NIH reports.
Urge incontinence is involuntary leakage associated with a sudden compelling desire to void. Urge incontinence is a symptom of overactive bladder and can be accompanied by urinary frequency, urgency, and/or waking up during the night to urinate. Initial treatments include bladder retraining, medications, avoidance of dietary irritants and pelvic floor physical therapy. When conservative therapies fail to provide significant relief, other options include Botox into the bladder, a pacemaker device for the bladder called InterStim, or percutaneous tibial nerve stimulation. 

The contents of this website are for informational purposes only and are not intended to be a substitute for professional medical advice, diagnosis, or treatment. Nor does the contents of this website constitute the establishment of a physician patient or therapeutic relationship. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.
Jill Rabin
OBGYN (Obstetrics & Gynecology)

The main goal of any treatment program is to allow the patient to develop control of bladder contractions. Treatments include:

• Behavior modification: retraining the bladder

• Physical therapy: mastering Kegel exercises, using vaginal weights, and
  using portable biofeedback muscle monitors

• Medications: selecting a medication that works with minimal
  uncomfortable side effects

• Internal devices such as pessaries or the Interstim

Surgery is generally not performed to relieve the symptoms of urge incontinence.

Do not let embarrassment, fear, or wrong information about incontinence prevent you from speaking to your doctor. The great majority of women suffering from urinary incontinence can be helped or completely cured. Call your physician and ask about a referral to a urogynecologist.

Mind Over Bladder: I Never Met a Bathroom I Didn't Like!

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OBGYN (Obstetrics & Gynecology)
Urgency incontinence is when a person has the overwhelming sensation to urinate and is unable to make it to the restroom.  Urgency incontinence is caused by bladder spasms.  When one's bladder is full, they have the overwhelming urgency to urinate, and when the bladder starts to spasm, the urethra relaxes and urine leaks out.  Most women with urgency incontinence do not leak just small amounts of urine, they leak large amounts of urine.  Urgency incontinence is commonly treated with frequent voiding as well as dietary changes.  Some people with urgency incontinence have an increase in bladder spasms when they drink caffeine, carbonated drinks, or any type of citrus drinks.  Urgency incontinence can also be treated with medications that help relax the bladder, but these medications are known to have side effects such as constipation and severe dry mouth.  Lastly, people with severe urgency incontinence can be treated with a procedure called InterStim, which is a surgical procedure where electrodes are placed through the sacrum to help desensitize the nerves going to the bladder and helping to relax the bladder and decrease bladder spasms.
Johns Hopkins Medicine
Behavioral therapies (to help people regain control of their bladder), including:
       Bladder training - teaches people to resist the urge to void and gradually expand the intervals between voiding.
       Toileting assistance - uses routine or scheduled toileting, habit training schedules, and prompted voiding to empty the bladder regularly to prevent leaking.

Pelvic muscle rehabilitation - Regular, daily exercising of pelvic muscles (Kegel exercises) can improve, and even prevent, urinary incontinence. This is particularly helpful for younger women to improve pelvic muscle tone and prevent leakage.

Biofeedback - Used in conjunction with Kegel exercises, biofeedback helps people gain awareness and control of their pelvic muscles.

       Vaginal weight training - Small weights are held within the vagina by tightening the vaginal muscles.

        Pelvic floor electrical stimulation - Mild electrical pulses stimulate muscle contractions which should be performed in conjunction with Kegel exercises for optimum results.

Medication - Specific drugs for incontinence as well as estrogen therapy can be effective. A class of medicines called anticholinergics help to decrease the number of voiding and incontinence episodes as well as the volume of any leakage.

Sacral nerve stimulation-  low level electrical stimulation directly to the pelvic nerves using a pacemaker-l;ike device can help restore bladder control for urge incontinence.

Surgery - effective if the incontinence is related to structural problems such as an abnormally positioned bladder or a blockage. Augmentation cystoplasty is one such operation associated with satisfactory results.

Diet modifications - eliminating caffeinated beverages as well as alcohol may reduce the symptoms of urinary incontinence.

Continue Learning about Urinary Incontinence Treatment

Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.