Urinary Incontinence in Women

Changes in habits (behavioral methods) and exercise are often used first to treat urinary incontinence because they do not involve surgery, have no serious side effects, can be done at home, and do not limit future treatment options. These methods are often successful in treating mild to moderate incontinence.

• Acupuncture: Acupuncture has been studied for improving urge incontinence, with promising results. In one well-done study, four weekly acupuncture treatments greatly improved women's urge incontinence, along with how much and how often they urinated.¹⁰
• Behavioral methods: These methods, which include bladder training and timed voiding, are used to treat urge incontinence.
• Exercises: Pelvic floor, or Kegel, exercises strengthen the pelvic muscles involved in urination and are used to treat stress or urge incontinence.
• Electrical stimulation: Electrical stimulation treatment uses a mild electrical current to stimulate the pelvic muscles that are involved in urination. Although not well-studied, this method seems to be more effective for urge incontinence than for stress incontinence.¹¹
• Mechanical devices: These devices include a pessary, which is a rubber device that is inserted into the upper vagina to lift the bladder to help control stress incontinence, and a catheter, which is a thin, flexible tube that a woman inserts into her bladder to drain urine (in a process called intermittent self-catheterization) to help control overflow incontinence.
• Absorbent products: These include adult diapers, plastic-coated underwear, pads, or panty liners that attach to underwear.
• Urethral bulking: Urethral bulking involves injecting collagen or other bulking materials around the urethra to build up the urethra where it leaves the bladder. This procedure usually relieves symptoms for about 1 year, although 2 to 3 injections are likely to be needed.⁶

Before trying other treatment options for urinary incontinence, ask your health professional the following questions:

• Is behavioral or exercise therapy alone likely to restore continence? Mild to moderate cases of common types of incontinence can be cured or greatly improved by these methods.
• How long should behavioral or exercise techniques be tried before surgery or other treatment methods should be considered? Since techniques like Kegel exercises do not limit future treatment options (and may even improve the odds of success for other treatments), it is best to set a length of time after which the improvement can be evaluated.
• Can exercises or behavioral methods be used in combination with medication if medication treatment is recommended? It may be possible to shorten medication therapy or to reduce the amount of medications used if other methods of treatment are combined with medication therapy.