TREATMENT FOR urge incontinence

Solutions to cure or significantly improve urge incontinence include: behavior and lifestyle modifications, medications, physical therapy and surgical neural stimulation.

Behavior therapy

Scheduled toileting— The patient empties her bladder at regular intervals, such as every two to four hours, to avoid an accident.

Double voiding— After you are finished voiding, try to go a second time for better emptying of bladder.

Fluid restriction— Decrease liquid intake, but be careful not to dehydrate.

Bladder retraining— The patient schedules trips to the bathroom at increasing intervals, thus retraining the bladder to hold the urine in longer.

Dietary instruction and/or weight loss—Avoid diuretics, such as alcohol and caffeine, as well as artificial sweeteners; try limiting food and beverages with high sugar or acid content, and spicy foods; if needed, lose weight to take pressure off bladder.

Pharmacologic

Oral medications—Ditropan (oxybutynin chloride), VESIcare (solifenacin succinate) and Detrol LA (tolterodine) and Toviaz (fesoterodine fumarate) cause relaxation of the smooth muscle of the bladder and are effective with urge incontinence, but not stress incontinence.

Topical estrogen—This can be effective for patients whose symptoms are caused by hormonal changes. It can improve the tone and blood supply of the urethral sphincter muscles, and may improve urinary frequency and urgency.

Physical therapy

Pelvic floor strengthening and/or rehabilitation—Pelvic floor muscle exercises, known as Kegels, can be effective in strengthening the pelvic floor to provide better support for the urethra and bladder, thereby treating incontinence.

Biofeedback—Special equipment can help you isolate the correct pelvic muscles. The equipment, which can be used in a healthcare setting or as a home device, sends a signal when the patient performs the correct contraction. It is generally very effective because the feedback (audio or visual) is an immediate indicator of whether the exercise is being executed correctly or not.

Other noninvasive

Perineal skin care—Maintaining skin health is very important for patients with chronic urinary incontinence. Our physicians will discuss ways to prevent dermatitis in the pelvic region, as well as restoring the skin’s integrity.

Surgical

Sacral nerve stimulation— Like a pacemaker for your bladder, sacral nerve stimulation uses a small, surgically implanted device to compensate for a natural body impulse that is not functioning properly. The small, implanted neurostimulator sends mild electrical pulses to the sacral nerve, which controls your bladder and the muscles related to urinary function. It’s a reversible treatment that may be recommended when more conservative treatments have not been successful.

Learn more about sacral nerve stimulation.

Botox injections—The use of Botox injections in treating urge incontinence has shown to be effective for some people. Botox may reduce the muscle contractions that cause the sudden urgent need to urinate.