How is stress urinary incontinence treated?

How is stress urinary incontinence treated?

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Stress urinary incontinence may not affect the body much physically beyond the uncontrollable urge to urinate. Perhaps more so than physically, stress urinary incontinence can also affect a person's quality of life and well-being.
People with stress incontinence should try to strengthen their pelvic floor muscles using pelvic floor exercises, or Kegels.  These exercises involve contracting and relaxing the muscles that control the flow of urine several times a day for up to six weeks.  You can locate these muscles by stopping the flow of urine during urination.  However, these exercises shouldn’t be performed regularly during urination, but rather when the bladder is empty.  A specially-trained physical therapist can teach the proper technique for these exercises and, in some cases, will offer biofeedback, a method to monitor and record the response of the pelvic floor muscles. 
Bladder sling surgery remains the standard of care when these other treatment options have failed. Patients have the best surgical results when they have tried pelvic floor exercises and practiced good bladder-emptying habits.  Like with any other surgery, patients should seek surgeons who have experience with the surgery and recovery from it, and should be honest with their surgeon about their previous treatments, habits and problems.
Stress urinary incontinence is the unintentional loss of urine with activities that put pressure on the bladder such as coughing or sneezing without an urge to urinate. Stress incontinence can be treated non-surgically with pelvic floor muscle exercises or with an outpatient surgery with a sling procedure or bulking agent. A sling acts to replace the weakened support tissue below the urethra. 

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Intermountain Healthcare
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Treatment can cure or improve most cases of stress incontinence. The treatment possibilities listed below may be used alone or in combination:

Lifestyle changes. Your doctor may suggest a weight loss program or a change in your diet. You may need to take steps to regulate the timing of your trips to the bathroom. If you smoke, your doctor will suggest you quit and will help you do so.
Strengthening the pelvic floor muscles. Certain exercises can strengthen the muscles around your urethra and may help control urine leakage. Kegel exercises -- tightening and relaxing the muscles that control urine flow -- are commonly recommended for this. For people who have difficulty with kegels, a doctor may recommend biofeedback or electrical stimulation to help strengthen the pelvic floor muscles.
Medication. Medication is sometimes used to treat mixed incontinence, in which symptoms of stress incontinence and urge incontinence are combined.
Pessary. For a woman with stress incontinence, the doctor may recommend using a pessary, a device that fits in the vagina to support the pelvic organs.
Injections. Your doctor may suggest injecting a bulking agent -- for example, collagen or another material -- into the tissues around the urethra and lower part of the bladder. The bulking agent can thicken the tissues to help close the bladder opening.
Surgery. Most of the time, a doctor will suggest surgery only after other treatments haven’t worked. The specific surgery recommended will depend on the cause of your incontinence.
Jill Rabin
OBGYN (Obstetrics & Gynecology)

Stress incontinence may be treated in a variety of different ways, depending upon the severity of the problem. In some cases, a combination of treatments may be prescribed. Your doctor will consider the cause of your problem and your needs, preferences, and personal goals for your treatment before making a recommendation on how to proceed. Conservative, nonsurgical treatments include:

• Lifestyle changes: weight management, dietary choices, and/or
  bladder training (timed voiding)

• Physical therapy: mastering Kegel exercises, using various types of
  available vaginal weights, using portable biofeedback muscle monitors,
  and pelvic floor electrical stimulation

• Mechanical devices: using a pessary or continence guard

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

A wide range of surgical procedures are available to treat stress incontinence. Surgery may be used to treat stress incontinence because it can restore the bladder and the urethra to their normal positions. By preventing downward sag and by creating support, surgery can help those who experience discomfort and who are unsuccessful with the less invasive techniques available.

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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.