Treatment for urinary incontinence

Urinary incontinence has a reputation of being something that only older women have to endure. However, many young people suffer from urinary incontinence. While more women than men are affected, men can have urinary problems as well. Fortunately, there are many effective treatments for urinary incontinence.

Here is a rundown of what is available:

• Behavioural treatment for urinary incontinence. Some people with urinary incontinence may get relief by making simple changes to lifestyle or behaviour. If you have stress incontinence, for instance, in which you leak urine when you cough, sneeze or laugh, your doctor may recommend that you limit how much you drink. If you have urge incontinence, in which you get the sudden urge to urinate and cannot always make it to the toilet in time, your doctor may advise you to avoid spicy foods, caffeine and carbonated drinks, because these can all irritate the bladder and make the problem worse. Exercises to strengthen the pelvic floor, sometimes known as Kegel exercises, are recommended for people with stress incontinence, which is due to weakened pelvic floor muscles. Pelvic floor exercises can also help people with urge incontinence. Sometimes pelvic floor exercises can be combined with biofeedback techniques to help you know if you are doing the exercises properly. For urge incontinence, bladder training, sometimes called bladder retraining, can also help. This involves gradually increasing the interval time between trips to the bathroom, working up to longer and longer intervals between toilet stops.
• Devices and absorbent product treatments for urinary incontinence. Protective pads and panty liners can help avoid embarrassing situations. A pessary, a plastic device inserted into the vagina, can help prevent urine leakage by supporting the neck of the bladder; it is most useful for stress incontinence.
• Medications for urinary incontinence. For urge incontinence, medication known as anticholinergics/antimuscarinics can prevent bladder spasms and are available with a doctor's prescription. Examples of these medications include oxybutynin, darifenacin, solifenacin, tolterodine and trospium.
• Surgical treatment for urinary incontinence. If behavioural and medical treatments for urinary incontinence do not provide enough relief, surgery may help. There are a number of different procedures each with its own pros and cons, so it’s important to discuss these with your specialist before deciding which is best for you. The surgical treatments include inserting a piece of tape to support the urethra, inserting a sling around the bladder neck to support it, or lifting and stitching the bladder neck to hold it in place. Another option is to inject a bulking agent into the wall of the urethra which allows the urethra to remain closed with more force.

When should you seek treatment for urinary incontinence?

How do you know when it is time to seek treatment for urinary incontinence? This is difficult to say precisely, but if you notice more urine leaking than previously, are avoiding social events, withdrawing from life, or feeling depressed, it is time to get medical attention.