Self-help techniques and aids can be used to treat mild stress incontinence. In addition, there are a number of treatments available for stress incontinence:
Kegel exercises: Kegel exercises, also called pelvic floor exercises, help strengthen the muscles that support the bladder, uterus, and bowels. By strengthening these muscles, you can reduce or prevent leakage problems.
To do Kegel exercises, pretend you are trying to stop the flow of urine or trying not to pass gas. When you do this, you are contracting the muscles of the pelvic floor. While doing these exercises, try not to move your leg, buttock, or abdominal muscles. In fact, no one should be able to tell that you are doing Kegel exercises.
Kegel exercises should be done every day, five sets a day. Each time you contract the muscles of the pelvic floor, hold for a slow count of five and then relax. Repeat this 10 times for one set of Kegels.
Device: The doctor can insert a device called a pessary into the vagina to stop stress incontinence. A pessary is a ring that, when inserted, puts pressure on the urethra in order to keep it in its normal location. Doing so can reduce urine leakage. Possible side effects from using a pessary include vaginal discharge and infections.
Injections: Bulking agents are substances that are injected into the lining of the urethra. They increase the size of the urethra lining. Increasing the size creates resistance against the flow of urine. Collagen is one bulking agent that is commonly used. If successful, periodic injections may be needed.
Surgery: When other methods for treating stress incontinence don’t work, surgery may be an option. Surgery is now minimally invasive and performed on an outpatient basis in most cases. There are three types of surgery designed to help keep the bladder in place and treat stress incontinence:
- Retropubic suspension: In this procedure, the surgeon makes an incision in the abdomen. The surgeon then attaches the neck of the bladder to the pubic bone with sutures.
- Sling procedure: In this procedure, the surgeon uses a sling made of either natural (human) tissue or synthetic material. The sling goes around the bladder neck and is attached to the pubic bone.
- Artificial sphincters: Most frequently used for men but also may be appropriate for women. A fluid-filled cuff is implanted around the urethra that can be opened and closed by the patient and that serves as a valve to contain the bladder content that might otherwise leak.
These surgeries can effectively treat the vast majority of stress incontinence cases. Side effects of surgery include continued or worsened incontinence or an inability to urinate.