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Treatment for UI in women
Treatment depends on the type of incontinence and severity of symptoms. For most people, simple lifestyle changes may be sufficient, for others, medication would be necessary. Finally some women may require surgery to treat the condition.
1. Lifestyle changes and physical exercises
– Limit fluid intake at certain times of the day (such as before going to bed or before a long trip). However, note should be taken to increase fiber content in your meals to prevent constipation.
– Cut down on caffeine, alcohol, keep a healthy weight.
– Try pelvic floor muscle exercises such as Kegel exercises. This is to strengthen the muscles that support your bladder and is particularly recommended after childbirth.
– Timed voiding or bladder training therapy : plan regular trips to the bathroom at set times of the day, gradually increase the interval between trips as you gain control.
– Keep a bladder diary: record the times of incidents to help your doctor identify the best treatment for your case.
– Small leakage can be managed by wearing menstrual pads.
Fig.1: Female urinary and reproductive organs, median section, side view. Note the pelvic floor muscles that support the urinary bladder and the uterus. Click on image to see a larger version on Alila Medical Media website where the image is also available for licensing.
2. Medication
– anticholinergics: these act on nerves to block bladder spasms in overactive bladder, for treatment of urge incontinence.
– estrogen: applied as a cream or patch can help to tone muscles and tissue around the urethra to keep it closed. This is a treatment for stress incontinence.
– some medicines used for treatment of other conditions such as high blood pressure or edema may have adverse effect on your bladder, talk to your doctor to find an optimal solution for your case.
3. Non-surgical therapies
– pessary: a medical device in the shape of a ring that can be inserted into your vagina to lift up the bladder. This helps if your condition is due to a prolapsed (dropped) bladder or uterus. The ring would need to be taken out and cleaned regularly.
– bulking agents injections: bulking materials such as collagen and carbon-coated beads are injected into the area surrounding the urethra to support and keep it closed. It’s a minimal invasive procedure but usually has to be repeated to be effective in the long term.
4. Surgery
Surgical procedures include:
– Sacral nerve stimulation: treatment for overactive bladder that does not response to medication. A small pulse generator device is implanted under the skin of the buttock, the device sends mild electrical impulses to the sacral nerve (the nerve that controls bladder activity) to moderate and control bladder spasms.
– A variety of procedures available to create an artificial support for the bladder neck and/or urethral sphincters: bladder suspension, sling procedures. These usually involve tightening of the bladder neck and/or urethra to strong ligaments within the pelvis or to the pubic bones.
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