What treatments are available for urinary incontinence?

Treatment for urinary incontinence depends on whether you have urge or stress urinary incontinence, says Jayram Krishnan, DO, a urologist at Sunrise Hospital. In this video, he describes testing that helps determine what kind and therefore treatment.
John E. Roddenberry, MD
OBGYN (Obstetrics & Gynecology)
Half of all women encounter issues with a leaky bladder (urinary incontinence) at some point in their lives. In this video, Eric Roddenberry, MD, of Coliseum Medical Centers, discusses an easy solution for this very common problem.
Dr. Mehmet Oz, MD
Cardiology (Cardiovascular Disease)

Some of the things you can do to stop urinary incontinence include:

Kegel exercises: This is the first line of defense against incontinence and involves contracting your pelvic floor (the same muscles you use if you try to stop your urine mid-flow) throughout the day to strengthen them. Experts recommend holding the contraction for 5 to 10 seconds, then relaxing for 10 seconds and doing repetitions of 10 to 20 throughout the day (maybe at stoplights, while watching TV, or before you go to sleep).

Vaginal weight training: It sounds silly, but experts swear by the use of cone-shaped vaginal weights that you must hold in while you go about your daily business, working up to 30 minutes a day. As your muscles strengthen, you increase the weights.

Behavioral therapy: You set times to go to the bathroom, and avoid caffeine and liquids at certain times of the day.


Physical therapy

Hormone cream (for caruncles)

Surgery to place a supportive sling under the urethra, help keep the bladder in its proper place, or bulk up the urethra to narrow the opening that urine flows through.
There are many options for successfully treating urinary incontinence. These may include behavioral therapy, medications, and surgery. These types of treatments may be used alone or together.

Behavioral therapy treatment options address a behavior or activity that can be changed.  These may include emptying the bladder on a schedule, delaying the urge to go to the bathroom, strengthening the pelvic floor muscles, or modifying diet and intake of fluids. About 80% of those with incontinence are able to improve symptoms with behavioral treatments.

The advantages of behavioral therapy include:

  •   May improve several symptoms
  •   No side effects
  •   It is the least expensive method of treating urinary incontinence
  •   It is usually recommended as the first method to try
  •   You play a major role in your treatment

Surgeries are performed by urologists and gynecologists to reduce stress incontinence symptoms.

Surgical treatment may be done to:

  •   Lift the bladder
  •   Tighten the valve
  •   Implant an artificial valve that goes around the urethra
  •   Inject collagen to stiffen the area around the urethra and bladder valve so it closes better
  •   Implant a small electrical device for nerve impulse and therapy to the bladder

Medications for urge incontinence decrease how much the bladder muscles contract. They help with urgency and frequency. However, they may have side effects such as dry mouth or constipation, and they are not suitable for individuals with glaucoma. Medications for stress incontinence are being researched and are expected to be available in the near future.

Some individuals may be embarrassed and reluctant to seek treatment for urinary incontinence. Yet, this is a problem that may easily be managed or cured. If the quality of your life is affected by this condition, talk with your healthcare team about getting help. You do not need to suffer with this problem.
Evelyn Minaya, MD
OBGYN (Obstetrics & Gynecology)
Watch as obstetrician and gynecologist Dr. Evelyn Minaya discusses treatment options for women with urinary incontinence issues.

Urinary incontinence can range from the constant urine dribble (overflow incontinence) to the occasional leakage of urine when you sneeze or cough (stress incontinence) to the strong, sudden urge to urinate followed by an involuntary loss of urine (urge incontinence) and everything in between.
Depending on the severity and cause of urinary incontinence, many treatment options exist:
Behavioral or Lifestyle Changes
  • Fluid and diet management- involves the modification of your daily habits to control your bladder.  These can include a decrease or avoidance of caffeine, alcohol or acidic food intake.
  • Timed urination- involves scheduling set trips (usually every 2-4 hours) to the toilet rather than waiting for the need to go.
  • Bladder training- learning to delay urination once you feel the urge to go.
Physical Therapy
  • Kegel exercises or pelvic floor muscle exercises- designed to strengthen your urinary sphincter and pelvic floor muscles (which help control urination).
  • Electrical stimulation- involves the temporary insertion of electrodes into the rectum or vagina to stimulate and strengthen the pelvic floor muscles
  • Anticholinergics- used to calm overactive bladder and include Ditropan, Detrol, Toviaz and Vesicare.
  • Topical estrogen- used to help tone and rejuvenate urethral and vaginal tissues; usually in the form of a cream, ring or patch.
  • Certain antidepressants can be used to help treat some forms of urge and stress incontinence.
  • Sling- involves the creation of a pelvic sling around the bladder neck and urethra to help keep the urethra closed, especially when you cough or sneeze.
  • Bladder neck suspension- provides support to the urethra and bladder neck
  • Urinary sphincter- implanted around the neck of the bladder and keeps the urinary sphincter closed until you are ready to urinate, which is done by pressing a valve implanted under the skin
It is important to discuss your urinary symptoms with your physician, so together you can design and begin a treatment plan.  For more information, visit:
Your doctor may recommend one or more of the following treatments, depending on the type, severity, and cause of your urinary incontinence and overactive bladder (OAB):

Behavioral techniques can help you strengthen the muscles around your bladder and help you recognize when you may be at risk of leaking, so you can prevent or avoid an accident.
  • Kegel exercises strengthen the pelvic floor muscles that support the pelvic organs, including the bladder and urethra.
  • Biofeedback shows you what's happening inside your body so you can learn to control your muscles in order to prevent leaks.
  • Bladder training helps you avoid accidents by teaching you to recognize when to go to the bathroom. You'll start by charting when you void and leak -- this will help identify triggers or patterns. Using that information, you can plan bathroom breaks ahead of when you would otherwise leak.

Medication can help treat some types of incontinence and overactive bladder. However, some of the drugs may cause side effects, such as dry mouth, eye problems, headache, abdominal pain, constipation, or urine buildup. If your doctor recommends medication, ask about the side effects and whether there are any drugs you shouldn't be taking at the same time.

Pessaries can be helpful when pelvic muscles are lax. A pessary is a device that, when inserted into the vagina, can ease stress incontinence by supporting the pelvic organs.

Catheters are often used to reduce overflow incontinence. A catheter is a soft tube that you insert through the urethra into the bladder to drain urine. It can be used temporarily, just when you need it, or it can be used constantly, in which case the tube connects to a bag that you can attach to your leg. If you experience pain or burning while using a catheter, tell your doctor. It could be a sign of a urinary tract infection.

Electrical stimulation of the pelvic muscles can help exercise them and make them stronger. Brief pulses of electrical stimulation may also stabilize overactive muscles.

Surgery is usually considered a last resort after all other treatments have been tried. But in some cases, when incontinence is caused by a bladder that has moved out of place, surgery may be the best option. The most common surgeries for incontinence involve lifting and supporting the bladder -- either with sutures, tape, or a sling -- closer to its original position.

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Celeste Robb-Nicholson
Internal Medicine
Urinary incontinence can be predominantly urge incontinence, which is caused by a bladder that contracts long before it is full, or stress incontinence, in which urine leaks during exercise, sneezing, or coughing. Several approaches have been successful in relieving incontinence:
  • Bladder control training. Women with urge incontinence practice consciously suppressing the urge to urinate for progressively longer intervals.
  • Fluid management. This approach is based on minimizing alcohol, caffeine and carbonated beverages; restricting daily fluids by 25%; and drinking slowly and no more than 8 ounces at a time.
  • Pelvic muscle strengthening. Exercising the pelvic muscles by contracting them and releasing them (as though grasping a tampon) can be performed by doing Kegel exercises, or involuntarily, with either electrical stimulation or pulsed magnetic fields. Biofeedback training may help you to locate and contract the muscles.
  • Weight loss. Studies have shown weight loss helps alleviate symptoms, although the mechanism is not known. It probably reduces abdominal pressure on the bladder.
  • Medication. Low-dose tricyclic antidepressants may help to alleviate all types of urinary incontinence. The cold medicine pseudoephedrine can help with stress incontinence, and several drugs that inhibit bladder contractions, such as Detrol, can relieve urge incontinence.
  • Botox. Injections of botulinum toxin are occasionally used off-label to reduce bladder contractions in patients with urge incontinence.
  • Electrical stimulation. Two treatment options stimulate the sacral nerve, which controls bladder contractions, to alleviate urge incontinence. One approach uses a device called Interstim, which is permanently implanted and resembles a cardiac pacemaker. The other, a procedure called percutaneous tibial nerve stimulation, is performed in a series of half-hour office visits. Both are moderately successful.
  • Injections. Collagen and other bulking agents can be injected around the urethra to create a tighter seal between it and the bladder. The procedure is used primarily for stress incontinence.
  • Surgery. Several bladder-suspension procedures are designed to raise the bladder and urethra with a sling of tissue or synthetic material to prevent urine from leaking. At least two sling procedures can be performed through band-aid incisions under local anesthetic. Hysterectomy is an option when incontinence results from uterine prolapse.
The following are treatment options for urinary incontinence:
  • Lifestyle changes
  • Bladder training (overactive bladder)
  • Fluid management (overactive bladder and stress incontinence)
  • Pelvic floor exercises (overactive bladder and stress incontinence)
  • Biofeedback (overactive bladder and stress incontinence)
  • Muscle conditioning without exercise
  • Electrical stimulation (overactive bladder and stress incontinence)
  • Pulsed magnetic fields (overactive bladder and stress incontinence)
  • Medications
  • Alpha-adrenergic agonists (stress incontinence)
  • Anticholinergics (overactive bladder)
  • Cholinergics (overflow incontinence)
  • Desmopressin (DDAVP) (bedwetting)
  • Tricyclic antidepressants (overactive bladder, stress incontinence, and nocturia)
For men: alpha-adrenergic antagonists (overflow incontinence).
For women: estrogen (sometimes prescribed for overactive bladder and stress incontinence; studies suggest that estrogen therapy does not improve incontinence, but not all experts agree with this conclusion)
  • Surgical procedures
  • Sling, male and female versions (stress incontinence)
  • Artificial urinary sphincter (reflex and stress incontinence); rarely used in women
  • InterStim sacral neuromodulation (severe overactive bladder in men; incontinence related to overactive bladder, urinary retention, or frequency in women)
  • Bladder neck suspension -- Burch procedure for women, open or laparoscopic (stress incontinence)
  • Other procedures
  • Injectable bulking agents (stress incontinence)
Jennifer S. Singer, MD
The treatments for urinary incontinence are many and varied and depend entirely on the cause of the incontinence. Treatments include behavioral interventions such as keeping bladder diaries to track and time bathroom visits, managing constipation, attending to properly timed bathroom visits during school daysand being patient with the voiding process (not stopping short of fully emptying the bladder). For cases related to infections, timely and proper treatment is essential. For cases related to bladder overactivity, bladder smoothmuscle relaxing medications can be helpful.And, for cases of incontinence related to neurological causes of bladder dysfunction or to urinary tract blockages, instituting bladder catheterization regimens or sometimescomplex surgical reconstructions may be necessary.

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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.