Stress Urinary Incontinence is a common issue among females, making daily life increasingly challenging as you age.
When it comes to stress incontinence, there are several treatment options. Your doctor can discuss the best course of action with you regarding pelvic floor exercises, medication, and surgery; each has its own risks and advantages.
Pelvic Floor Exercises
If you’re female and experience stress incontinence (the involuntary leakage of urine when doing certain activities), pelvic floor exercises may help. They not only improve control over leaks but also decrease the likelihood of urinary tract infections or UTIs.
Pelvic floor muscle exercises strengthen the muscles that keep your urethra, bladder, uterus, and rectum in place. They can also prevent and treat pelvic organ prolapse (POP), in which organs shift out of position due to a weak pelvic floor.
Kegel exercises, which involve squeezing your pelvic floor muscles, can also improve orgasms and sexual health. They’re generally safe and effective for most people; however, it’s best to consult your healthcare provider before beginning these activities.
Women often make the mistake of performing pelvic floor exercises incorrectly, contracting their buttocks, gluteals, or inner thighs instead of the pelvic floor muscles. Doing this incorrectly can put undue strain on your symptoms so it’s essential to focus on performing them correctly.
Kegel exercises involve lying flat on your back and tightening the pelvic floor muscles as hard as you can. Hold the contraction for up to 10 seconds, then release them completely. Repeat these exercises regularly in order to build strength and confidence in yourself.
Another exercise to strengthen your pelvic floor is pulling ups. You can do this while standing, lying down or crouching on all fours. Tighten the pelvic floor muscles from back to front as hard as you can and then slowly relax them again. Try doing these exercises for at least 5 minutes daily, at least three times.
This can help prevent leaks during normal everyday activities like laughing, coughing, or sneezing. Additionally, it may help control sudden urges to urinate.
If you suffer from mild to moderate stress incontinence or urge incontinence, these exercises can be done at home. However, if the problem is persisting, speak to your healthcare provider about getting assistance from a specialized physical therapist who can teach you how to do these exercises safely and effectively.
Lifestyle Changes
If you struggle with urinary incontinence (UI), it may be beneficial to try some simple but effective lifestyle modifications that could help relieve your symptoms. These could include avoiding certain liquids, exercising regularly, and increasing fiber intake.
Liquids – Reducing liquids such as caffeine or alcohol and replacing them with water can improve bladder control. This is especially helpful if you have an underlying medical condition like diabetes or high blood pressure.
Exercise – Regular physical activity, especially pelvic floor exercises, can help strengthen your bladder muscles and reduce leakage.
Weight Loss – For those who are overweight or obese, losing weight may help to reduce urine leakage.
Diet – Eating a low-fat, high-fiber diet can help regulate incontinence and alleviate other chronic health conditions associated with it, such as constipation.
Precautionary Products – Utilize pads, liners, and underwear that act as absorbent barriers between you and your clothing or shoes. These can help prevent leaks when in vulnerable positions such as sitting down or lying down, or when you feel the sudden urge to urinate.
Avoiding irritants and stress-producing activities can also help to reduce incontinence. For instance, avoid coughing, laughing, and sneezing which all put pressure on the bladder and urethra and increased urination.
Additionally, try to avoid prolonged periods of standing or sitting as this can put additional strain on the bladder and urethra. Moreover, try increasing the time between bathroom trips.
If you suffer from urinary incontinence, it’s wise to speak with a doctor about the best treatment options for your individual needs and situation. There are various treatments available, including nonsurgical remedies and surgical options.
Behavior therapy, which is typically taught in an outpatient setting, can be a safe and effective treatment for incontinence. These therapies aim to alter behaviors to achieve improved urinary control and may be used alone or combined with other treatments.
Many people with stress incontinence find that lifestyle changes can help them manage their condition and symptoms. If you have UI and would like more information on these strategies, please reach out and we’ll assist in getting you on your way toward improved quality of life.
Medications
Treatment for stress incontinence in females is necessary to alleviate symptoms and enhance the quality of life. There are both nonpharmacological and pharmacological therapies that can assist with this type of urinary incontinence.
Nonpharmacological therapies aim to strengthen pelvic floor muscles and modify behaviors that impact bladder function, while pharmacological treatments target bladder innervation and sphincter function. Examples of nonpharmacological therapies available for stress UI include:
Pelvic muscle exercises (Kegels), when done regularly, may reduce leakage and the urge to urinate. Furthermore, these exercise programs help prevent future episodes.
Vaginal inserts, which are temporary devices that may be inserted into the vagina or rectum, can help with urinary incontinence. These inserts support the urethra and reduce urgency sensation by compressing or elevating the neck.
Urethral bulking, which involves inflating tissue around the urethra to provide structural support, can be an effective symptom-reducing therapy for stress UI. This therapy may involve surgery or non-surgical solutions depending on how severe the incontinence and how much it interferes with daily activities are affected.
Medications — While medications for incontinence are usually not necessary, some women do require them to get their bladder leakage under control. These drugs fall under two categories: anticholinergics and beta-adrenergic.
Anticholinergics are drugs that work by inhibiting the release of acetylcholine, a chemical involved in urgent incontinence. Common uses for anticholinergics include darifenacin, fesoterodine, and oxybutynin.
Beta-adrenergic is drugs that work by stimulating the muscles of the bladder and sphincter to loosen and relax them, thus decreasing urine production. They’re typically prescribed to treat overflow incontinence but may also help with stress incontinence or other types of urinary retention (UI).
Topical estrogen, applied directly onto the vagina or rectum, may help with both stress and urgency incontinence by increasing the tone of bladder muscles and sphincter muscles. It may be combined with other treatments like behavioral therapies, vaginal inserts, or electrical stimulation for maximum effectiveness.
Surgery
Stress incontinence can be treated surgically through either vaginal sling surgery or abdominal coloposuspension. Before making the decision whether surgery is right for you, discuss your symptoms with your doctor and the available treatments.
Most women who opt for surgery will have already tried pelvic floor exercises (Kegels), lifestyle modifications, and medications before their surgeon suggests surgery as a treatment for stress incontinence. They should be aware of potential risks such as difficulty urinating after the operation and issues with the mesh tape used during the procedure.
Stress incontinence occurs when the muscles of your bladder cannot maintain normal pressure on the urethra and bladder neck, leading to leakage of urine.
The purpose of surgery is to support the urethra and bladder neck so they remain closed when you exert pressure, helping prevent leaks. This can be accomplished through repair or repositioning either the urethra, bladder neck, or both.
Surgery for stress incontinence is usually the last resort when other therapies have failed. Your urogynecologist or urologist will perform tests to diagnose your type of incontinence and recommend a tailored treatment plan tailored to your individual requirements.
Your doctor can also prescribe medications, such as narcotics, to ease the discomfort caused by incontinence. These drugs will suppress your urge to urinate and help you get through activities that cause urinary leaks.
If your doctor recommends surgery, you’ll have a preop period – the time between scheduling the procedure and being wheeled into the operating room. During this period, you can ask any questions about the surgery or prepare for your hospital stay with them.
Before your surgery, your doctor will administer anesthesia to make sure you’re unaware of anything about yourself or any pain during the process. You have a choice between general or spinal anesthesia.
After your surgery, you will remain in the recovery room for several hours to become comfortable and ready to resume daily life. A catheter may be necessary during this period to facilitate urination; additionally, refrain from coughing, sneezing, sexual intercourse, lifting heavy items, and straining during urination as these activities can put undue stress on surgical sutures.
