Other Treatments for Urinary Incontinence

Behavioral Therapy

Bladder retraining is often an initial treatment for incontinence, and it requires that you have at least some control over bladder function. For example, if you know that you tend to leak urine three hours after you urinate, you could empty your bladder every 2½ hours, then gradually increase the interval between trips to the bathroom.

Exercises

Not all the muscles involved with bladder control are automatic. You have control over the sphincter that holds urine in. Therefore, you can strengthen it by doing Kegel exercises:

• Tighten the muscles in your bottom as if you were holding in urine and bowel movements. These muscles contract together.
• Hold them as tight as you can for a slow count of ten.
• Relax.
• Repeat 10 times each session and several sessions each day.

Devices

Pessaries are devices inserted into the vagina. Most are designed to improve the function of the bladder sphincter by supporting the floor of the bladder.

Catheterization

Regularly emptying the bladder by inserting a tube (catheter) keeps the urine from spilling uncontrollably. Patients with neurogenic bladders can learn how to do this by themselves. Those who are incapable of caring for themselves may need a catheter that remains in permanently.

Nerve Stimulation

To stimulate the nerves, there are devices like Urgent PC and InterStim. The procedure may involve implanting a thin lead wire with a small electrode tip. In some cases, the tibial nerve, which extends down to the ankle, is stimulated. This electronic stimulation therapy can be done as a series of treatments in the doctor's office.

Biofeedback

By using electrical sensors, it is possible to make the contractions of the sphincter muscle visible or audible. While attached to such a device, you are encouraged to increase the signal, which strengthens the involved muscle. This form of treatment has not yet become widely accepted.

When to Contact Your Doctor

Except for catheterization, these methods are relatively safe. If you are doing your own catheterization, you will have a training session that will teach you when to call for help, such as:

• Signs of urinary tract infection
• Difficulty inserting or removing the catheter
• Bleeding
• Pain