The different kinds of incontinence treatment include behavioral techniques and lifestyle modifications, physical therapy, prescription medication, and non-surgical and surgical procedures. Treatment for incontinence usually includes a combination of therapies, and physicians often recommend the milder forms of treatment first. The types of therapies that may be included in a treatment plan will depend on why the incontinence has occurred.
Behavioral techniques that may be incorporated into an incontinence treatment plan include bladder training and fluid management. Bladder training can be used to gradually increase the time between urinations to reduce a continual and sudden urge to urinate; training methods can include trying to urinate again a few minutes after urination to teach the bladder to completely empty itself. Fluid management involves reducing intake of fluids, such as coffee, tea and soda, that can increase urination or irritate the bladder.
Physical therapy exercises that are used to treat incontinence strengthen the pelvic floor and urinary sphincter muscles, two muscles vital to control over urination. The pelvic floor and urinary sphincter muscles may be strengthened through repeated and daily exercises known as Kegels, which are performed by contracting and holding the muscles used to stop the flow of urine. Rectal or vaginal electrical stimulation may be used to strengthen the muscles, as well.
When behavioral and physical therapy incontinence treatment plans are not effective, prescription medications may help. Anticholinergics are often prescribed to relieve bladder spasms that are contributing to a sudden and uncontrollable urge to urinate. Incontinence that tends to peak during times of high stress may be treated with a prescription tricyclic antidepressant. A low dose of prescription topical estrogen may help to control incontinence in post-menopausal women. Ideally, the prescriptions are only used to control incontinence until other therapies successfully treat the condition.
Non-surgical incontinence treatment methods include radiofrequency therapy and stimulating the sacral nerve. Radiofrequency therapy uses heat to lightly burn the tissue in the lower part of the urinary tract; when the tissue heals, it may be firmer, reducing the amount of urinary leaks. Stimulating the sacral nerve with a low-voltage electrical impulse through a device implanted under the skin may reduce incontinent caused by sudden urges to urinate.
Surgical procedures that may be used to treat incontinence include implantation of an artificial urinary sphincter, creation of a bladder sling, and using a series of incisions and sutures to create an artificial bladder neck suspension. The type of surgery that may be required for incontinence treatment will depend on the cause of the incontinence. For example, an artificial urinary sphincter is recommended for men who experience incontinence as a result of prostate cancer treatment. All surgeries have risks, and there are risks for incontinence procedures; patients also will need to allow themselves time to recover.