Questions about Treatment
How is urinary incontinence treated?
Treatment for urinary incontinence depends on the type of incontinence, how severe it is, and what may cause it. There is no single solution to incontinence that works for everyone. The various treatment options for urinary incontinence can be grouped under self-management or lifestyle changes, drug treatment, and surgery.
How can lifestyle changes help when you suffer from urinary incontinence?
Your diet can have an effect on urinary incontinence. By looking at when, what, and how much you drink or eat, you may find behaviours which worsen your condition. Small changes to your dietary habits can offer some improvement.
What is the purpose of bladder training?
Your doctor may recommend a course of bladder training. The first step of the training is to keep a bladder diary. Here you record how much you drink, how often you urinate, and how much urine you produce. Based on this information your doctor will propose a schedule for urinating. By following the schedule you train your bladder. If training is successful, the bladder can also hold more urine.
What is the purpose of pelvic floor muscle exercises?
A structured programme of exercises to strengthen the pelvic floor muscles can improve urinary incontinence. It consists of a series of exercises to train the pelvic floor muscles, which is designed specifically for your needs.
What are the main drugs used to manage urinary incontinence?
The main types of drug treatment used to manage incontinence are:
- Muscarinic receptor antagonists. These drugs are most commonly used to treat urgency urinary incontinence (UUI). MRAs can be used to manage the frequent need to urinate at night, a condition known as nocturia.
- Oestrogen: Local oestrogen therapy can be recommended for women who suffer from urinary incontinence and have already gone through menopause.
- Desmopressin: Desmopressin limits the amount of urine the kidneys produce. This drug can reduce the need to urinate at night. Desmopressin can improve frequency and urgency symptoms, but it does not improve or cure incontinence.
- Duloxetine: This drug can be used for improving moderate to severe urinary incontinence, but will not cure it. The drug strengthens the sphincter muscle, and reduces involuntary nerve signals which lead to urine leakage. It makes the sphincter muscle more resistant to pressure from the bladder.
What is the purpose of surgery for urinary incontinence?
The main purpose of all surgery for urinary incontinence is to make you continent. Surgery is generally only recommended after self-management and drug therapy have not been effective.
What are common types of surgery for stress urinary incontinence?
If you suffer from SUI, your doctor may recommend surgical treatment.
Common treatment options for SUI are:
- Sling implantation: Slings provide support to the pelvic floor muscles and help the urethra to better resist pressure from a full bladder. Slings are placed under the urethra to support it.
- Injections with bulking agents: If you suffer from SUI, your doctor may recommend treatment with bulking agents. These are injected into your urethral wall so that the urethra is compressed and can better resist the pressure of a full bladder.
- Artificial compression devices (balloon insertion): Artificial compression devices, also known as balloons, are a second-line treatment for moderate to severe stress urinary incontinence (SUI). They compress the urethra just below the bladder neck so that it can better resist the pressure of a full bladder. The goal of the balloons is to reduce urine leakage during activities such as sneezing, coughing, laughing, or running.
- Artificial Urinary Sphincter implantation(AUS): Artificial urinary sphincter implantation, or AUS, is a second-line treatment for moderate to severe SUI. With the help of a hand-controlled pump, the AUS allows you to control your bladder by compressing and releasing a cuff around the urethra. The goal of the AUS is to reduce urine leakage during activities such as sneezing, coughing, laughing, or running.
- Burch colposuspension: This surgery is a treatment for SUI in women. The aim is to reposition the bladder neck so that it can better resist the pressure from a full bladder.
What are common types of treatments for urgency urinary incontinence?
Sometimes self-management or the drugs your doctor prescribed do not improve your urgency urinary incontinence(UUI). In these cases, other treatment options are available. Together with your doctor you can decide which approach is best for you.
Common treatment options for UUI are:
- Botulinum toxin bladder injection: Botulinum toxin is widely known by one of its trade names, Botox® and is often used in cosmetic surgery. For UUI, the toxin is injected into the bladder wall to reduce the activity of the nerves which cause the symptoms.
- Nerve stimulation: Nerve stimulation, also known as neuromodulation, is a treatment which uses electrical pulses to stimulate the sacral nerves, which control the bladder. The electrical pulses can be directed to the tibial or the sacral nerves.
- Surgery to increase bladder volume: In case your symptoms have not improved with drug or other treatments, you may need surgery on your bladder. The goal of the procedure is to increase the capacity of the bladder. This will reduce the pressure in the bladder as it fills so that it can hold more urine.