What Are the Treatments for Urinary Incontinence?

Problems with urine leakage or an uncontrollable urge to urinate make it difficult to enjoy an active and productive life. While a number of treatment options exist to treat urinary incontinence, the problem is often regarded as a source of embarrassment, resulting in a reluctance to discuss the problem with a doctor. A survey conducted by the National Association for Continence revealed that people with bladder control problems often waited seven years before seeing a doctor. Treatment for urinary incontinence varies depending on the cause of the problem.

Types

• If you have stress incontinence, you may leak urine when you laugh, cough, sneeze or exercise. The problem occurs when the urethra and bladder neck fail to close completely, allowing urine to leak out through the urethra. Childbirth, menopause and pelvic surgery can contribute to the weakening of the urethra sphincter and pelvic floor muscles.

  Urge incontinence occurs when you have a sudden urge to urinate and may have an accident if you don't reach a bathroom quickly. Several neurological disorders are associated with urge incontinence, including multiple sclerosis, Alzheimer's disease, diabetes, Parkinson's disease, and brain and spinal cord injuries and tumors. If you have overflow incontinence, you may leak small amounts of urine constantly but never feel the urge to urinate. Overflow incontinence is more common in older men who have an enlarged prostate gland.

Medications

• A variety of medications are available to decrease urinary frequency and urges. Oxybutynin chloride, propantheline bromide and anticholergic agents work by relaxing smooth bladder muscle and reducing spasms and involuntary contactions. Tolterodine tartrate reduces urgency and frequency in people who have urge incontinence or overactive bladder. Tricyclic antidepressants can be helpful in reducing incontinence at night and reducing episodes of urge incontinence. Alpha blockers are used to treat men with enlarged prostate glands. These drugs work by decreasing the amount of resistance in the urethra and relaxing bladder muscle.

Devices

• Vaginal pessaries are small devices that are placed in the vagina to support the neck of the bladder and compress the urethra, preventing urine leakage. Pessaries are removable and must be cleaned on a regular schedule to prevent infection. The FemSoft is a disposable device that is inserted into the urethra. It works by sealing the bladder neck and is removed when the user wants to urinate. Penile clamps can help men who suffer from incontinence. The clamp fits over the penis and prevents urine from escaping. Silicone caps and disposable foam pads are placed over the urethra and apply pressure to the urethral opening, preventing leakage in women. These devices are removed for urination.

Surgery

• When other treatment methods don't help control your symptoms, surgery may be needed. Common surgical procedures for urinary incontinence include bladder neck suspension surgery to support the bladder neck and urethra, and the needle suspension procedure that uses sutures to anchor tissues on both sides of the bladder neck to the pubic bone or fibrous tissue. A sling procedure can be used to create a sort of hammock around the urethra and bladder neck with mesh, tissue from your body or synthetic material. The sling is helpful in treating stress incontinence and prevents urine leakage when you sneeze or cough. An implanted device, called an artificial urinary sphincter, can help men who have problems due to an enlarged prostate gland or the effects of prostate surgery. A ring filled with fluid keeps the sphincter shut until you need to urinate. The ring is then deflated by deactivating the valve placed under your skin.

Other Treatments

• Exercises to strengthen pelvic floor muscles, nerve stimulation, limiting caffeine intake, and bladder training can be helpful in reducing episodes of urinary incontinence. Injecting collagen or fat to increase the bulk around the urethra can help improve sphincter function in women.