How is stress incontinence treated?

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Ja-Hong Kim, MD
Urology
Stress incontinence - the type of incontinence caused by coughing, sneezing or lifting something heavy - can be treated a variety of ways, beginning with pelvic floor muscle exercises. Just like your arms and legs, your pelvic floor is made of muscles that weaken if you don’t use them. Kegel exercises, where you squeeze the pelvic floor to gain strength, can improve incontinence; if you give that squeeze while coughing or sneezing, you can make that sphincter tighter and prevent an accident. Kegel exercises must be done correctly, however; Like lifting weights, you need to squeeze and hold for five seconds to build muscle tone. Patients who have trouble with the exercises can work with pelvic floor therapy specialists.
 
Other treatments for stress incontinence involve putting bulking agents into the urethra to make the urethral lumen tighter so that you won’t leak as much. Doctors can also insert a sling, which wraps around the urethra like a hammock and supports it. Injectable therapy is another option, particularly for people who are older and may not be candidates for bigger surgery like a sling.
 
There are several treatment options for women who are suffering from stress incontinence. In this video, Justin Parkinson, MD, an urologist at Lakeview Hospital discusses therapies including muscle training and surgery.
Kevin W. Windom, MD
OBGYN (Obstetrics & Gynecology)
Stress urinary incontinence (SUI) is caused by a hypermobility of the urethra.  Some people are able to remedy their SUI by performing pelvic floor exercises (Kegels).  If this does not  remedy their incontinence, then there are numerous surgical options.  The most common surgery performed is a pubourethral sling.  The sling procedure places a polypropylene or biologic graft/mesh underneath the urethra in order to cause a kinking of the urethra when the patient coughs, sneezes, or does any type of physical activity.  This procedure can be performed in which the graft is anchored around the stomach muscles(TVT) or the graft is anchored through the groin(obturator) muscles(TOT).  The 5-year success rate of this surgical procedure is approximately 90% and it is minimally invasive and most people are able to return back to work in 1-2 weeks.

Because there are so many causes for stress urinary incontinence, there are many treatment options. In some cases, treatment may be as simple as training your bladder or changing your lifestyle, such as avoiding alcohol if it increases your bladder's instability. Physical therapy, such as pelvic floor muscle exercises known as Kegels, may help SUI. Medications, medical devices, or surgery can be used in other cases.

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.