Three major categories of urinary incontinence treatment are behavior change, medication and surgery.
- Scheduled toileting – A person with urinary incontinence is prompted to go to the bathroom every two to four hours. This puts the person on a regular schedule. The goal is simply to keep the person dry. This is frequently recommended as therapy for frail elderly, bedridden or Alzheimer's patients.
- Bladder or bowel retraining – Bladder retraining involves scheduled toileting, but the length of time between bathroom trips is gradually increased. This therapy trains the bladder to wait for larger time intervals.
- Pelvic muscle rehabilitation– This technique involves pelvic muscle exercises which strengthen the muscles that control the flow of urine. Pelvic floor rehabilitation includes an assessment and treatment of pelvic floor disorders. The initial evaluation consists of the therapist assessing:
- Joint motion
- Muscle strength
- External and internal examination
The treatment plan may include:
- Posture education
- Therapeutic exercise
- Relaxation and stress management training
- Muscle stimulation
- Manual therapy such as massage and trigger point release
Most patients are seen 1-2 times a week for 8-12 weeks on average.
Your doctor may prescribe medications to help control your incontinence. Medications can relax the bladder and reduce spasms or instability. These drugs also can help prevent the bladder from contracting spontaneously.
If medication or behavior changes are not effective, many different surgical procedures may be used to treat urinary incontinence. The type of operation recommended depends on the type and cause of your incontinence. Some of the more common procedures performed to treat urinary incontinence include:
- Bladder (retropubic) suspension – This procedure supports and stabilizes the bladder and urethra by attaching one or both to a sturdy structure in the pelvis, such as the back or pubic bone.
- Urethral bulking – This involves injecting collagen into the urethra to close up a hole or build up its walls.
- Artificial sphincter – This involves implanting an artificial cuff around the neck of the bladder. The cuff can be inflated to put pressure on the urethra and prevent urinary incontinence, and deflated when it is time to empty the bladder.