Behavioral therapies, vaginal inserts, electrical stimulation and surgery are the three treatment options for women with stress incontinence. The objective is to rehabilitate the pelvic floor by building the strength and function of the muscles that support the bladder, urethra and other organs contained within the pelvic region.
Behavioral treatments are simple, self-directed, have no side effects and are often used in conjunction with other treatment options. They have proven effective for many women and work well for certain types of incontinence. They include:
Vaginal inserts and pessaries are frequently used to treat bladder and pelvic support problems. These devices are placed into the vagina to provide support for the uterus, bladder, urethra and rectum. A number of types are available, and the inserts are fit to meet your needs and anatomy.
Pelvic floor electrical stimulation uses low-grade electrical current to stimulate weak or inactive pelvic muscles to contract. A tampon-like sensor that connects to a handheld adjustable device is inserted in the vagina. The patient then increases the current to the level of a comfortable tingle. Regular electrical stimulation sessions can supplement or augment your pelvic muscle exercise regime. Units are available for home use and may be covered by Medicare or insurers.
Surgery is performed to restore the normal position of the bladder neck and urethra. There are two main types of operations for incontinence: bladder neck suspension procedures and sling procedures. Within the medical community, the comparative effectiveness of these procedures is still being debated. If you are considering surgery, it is important that the decision be based on your individual circumstances.
There are currently no medications marketed specifically for the treatment of stress urinary incontinence. However, there are several experimental medications in development. Medications for this condition should be available in the near future.
Estrogen replacement therapy taken in pill or skin patch form has not been shown to be an effective treatment for female urinary incontinence. Vaginal estrogen (creams, vaginal rings or vaginal pellets) have helped reduce recurrent urinary tract infections in postmenopausal women, but their effectiveness for incontinence is unknown.
Reviewed by health care specialists at UCSF Medical Center.