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Your doctor will ask about your symptoms and medical history. You will be asked how often you empty your bladder and patterns of urine leakage. Your doctor will do a physical exam to look for any physical causes such as blockages or nerve problems. You may be referred to a specialist.
Your bodily fluids will be tested. This can be done with:
The flow of your urine will be assessed. This can be done with:
Your bodily structures may need to be viewed. This can be done with:
Treatments are based on the cause of the urinary incontinence.
Temporary incontinence may be relieved by managing the conditions associated with the incontinence.
Weight loss may help reduce the number of episodes due to stress or urge incontinence in people who are overweight or obese. Talk to your doctor about a
weight loss program
that is right for you.
Initial treatment relies on behavior changes and strengthening pelvic floor muscles. Behavior changes include:
Limiting the amount of fluids consumed throughout the day.
Decreasing caffeine—caffeine has been linked to worsening of urinary incontinence.
Planning frequent bathroom trips throughout the day to prevent accidents.
Methods to increase strength in the pelvic floor muscles include:
Kegel exercises—focuses on muscles that hold the bladder in place and those that control urine flow.
Painless electrical stimulation—may strengthen the muscles more quickly; helpful for stress incontinence.
Pelvic floor exercises using cone-shaped weights that are placed in the vagina.
Biofeedback—a device signals how strong you are at contracting your muscles during exercise.
Surgical procedures may be done for incontinence that is not responding to these treatments. Surgical options include:
Placement of strips of material or sutures to support structures in the area and relieve pressure on the urethra. There are several different types of surgery but a common option, called a
urethral suspension uses mesh to help support the urethra.
Collagen injection into the wall of the urethra. This substance bulks up the wall of the urethra to help stop leaks.
Initial treatment depends on behavior changes and strengthening pelvic floor muscles. Behavior changes include:
Drinking less fluid throughout the day
Avoiding caffeine and alcohol
Avoiding drinking at bedtime
Keeping a log of urination schedule and accidents.
Kegel exercises can help strengthen pelvic floor muscles and relieve some symptoms.
Medications may be recommended. Anticholinergics is the most common medication. They can relax the muscles of the bladder. Other medications may be used in combination to help manage symptoms, such as botulinum toxin injections.
Nerve stimulation may be used if urge incontinence does not respond to behavior modification or medication. A device will send pulses to the nerves that control the bladder. This has been shown to help stimulate bladder control. In some cases, the device is implanted in the back.
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3/5/2010 DynaMed's Systematic Literature Surveillance ...(Click grey area to select URL) Vardy MD, Mitcheson HD, Samuels TA, et al. Effects of solifenacin on overactive bladder symptoms, symptom bother and other patient-reported outcomes: results from VIBRANT—a double-blind, placebo-controlled trial. Int J Clin Pract. 2009;63(12):1702-1714.
12/3/2010 DynaMed's Systematic Literature Surveillance ...(Click grey area to select URL) Cardozo L, Khullar V, Wang JT, Guan Z, Sand PK. Fesoterodine in patients with overactive bladder syndrome: can the severity of baseline urgency urinary incontinence predict dosing requirement? BJU Int. 2010;106(6):816-821.
12/13/2010 DynaMed's Systematic Literature Surveillance ...(Click grey area to select URL) University of Texas at Austin, School of Nursing, Family Nurse Practitioner Program. Recommendations for the management of urge urinary incontinence in women. Agency for Healthcare Research and Quality website. Available at: http://www.guideline.gov/content.aspx?id=16322. Published May 2010. Accessed December 13, 2010.
3/5/2013 DynaMed's Systematic Literature Surveillance ...(Click grey area to select URL) Boyle R, Hay-Smith EJ, Cody JD, et al. Pelvic floor muscle training for prevention and treatment of urinary and faecal incontinence in antenatal and postnatal women. Cochrane Database Syst Rev. 2012 Oct 17;10:CD007471.
4/29/2014 DynaMed's Systematic Literature Surveillance ...(Click grey area to select URL) Chang SR, Chen KH. Association of mode of delivery with urinary incontinence and changes in urinary incontinence over the first year postpartum. Obstet Gynecol. 2014;123(3):568-577.
7/28/2014 DynaMed's Systematic Literature Surveillance ...(Click grey area to select URL) Mangera A, Apostolidis A, et al. An updated systematic review and statistical comparison of standardised mean outcomes for the use of botulinum toxin in the management of lower urinary tract disorders. Eur Urol. 2014;65(5):981-990.
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This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.