The treatment that a urologist may recommend for stress incontinence depends on how troubling the condition is to the woman and on the woman’s general fitness level. Often, the urologist will opt for fairly simple treatment options for a less troubling condition and only recommend surgical treatments when absolutely necessary. For instance, if an overactive bladder is present, the urologist will determine the possible contributing factors and recommend deterrent treatments such as fluid modification and caffeine reduction. Likewise, for women whose body mass index (BMI) is equal to or over 30kg/m2, the urologist will recommend weight loss.
Generally, the most common treatments for stress incontinence are:
- Weight loss: For women who are overweight or obese, losing weight helps to reduce urine leakage.
- Fluid management: For women who drink large amounts of fluids daily, cutting back on fluids reduces urine leakage. This includes reducing the amount of caffeinated, alcoholic and carbonated drinks. In fact, avoiding fluids 3-4 hours before going to bed helps a lot to prevent frequent nighttime urination.
- Avoiding constipation: Since constipation worsens urine leakage, increasing the quantity of dietary fiber to 30 grams or more per day will prevent constipation and reduce incontinence.
- Pelvic floor muscle exercises: Exercises for tightening pelvic floor muscles will help control stress incontinence.
- Bladder training: Bladder retraining helps affected women to regain bladder control and hold more urine for longer. Bladder training involves going to the bathroom on a specific schedule while awake and applying various strategies to control any sudden urges./li>
When the above options fail, the urologist may recommend:
- Bladder control medicines: For example, the drug duloxetine is used to treat stress incontinence in women who are unwilling or whose incontinence is unsuitable for surgical treatment. Collagen injections around the neck of the bladder may also be used when surgery is not ideal.
- Topical vaginal estrogen may be recommended for peri-menopausal or post-menopausal women with vaginal atrophy and stress incontinence.
- Pessary: A pessary, a stiff ring inserted into the vagina to push up against the wall of the urethra and the vagina, may be applied to reposition the urethra and reduce stress leakage.
- Catheterization: This treatment is used in women who are incontinent because the bladder never empties fully (overflow incontinence) or when the bladder cannot empty completely because of a spinal cord injury, past surgery or poor muscle tone.
- Biofeedback: The therapist puts an electrical patch over the bladder and urethral muscles, uses a wire to connect the patch to a TV screen where the contraction of these muscles is monitored, then with this information uses electrical stimulation and pelvic floor exercises to control stress incontinence.
As a last resort and depending on the severity of the stress incontinence, the urologist may opt for surgery. Surgery for stress incontinence is the most effective treatment for women who have not been helped by other treatments. Common surgical procedures are anterior vaginal wall repair surgery, colposuspension, surgical tape procedure and laparoscopic (keyhole) surgery. If you have urinary incontinence, speak with your doctor about whether surgery will help you and what type of surgery is perfect for you.
At Advanced Urology Institute, we have a solid track record of helping men and women plagued with urinary incontinence put their lives back on track. We have state-of-the-art facilities and skilled, board-certified urologists to assess, diagnose and treat any type of incontinence. For further help with urological disorders, visit the site, Advanced Urology Institute.