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Regaining bladder control is possible thanks to various treatment options.

Urinary incontinence is a common experience for many women, especially after age 50, during pregnancy and after giving birth. However, there is no need to suffer through it.

鈥淭here is almost always something we can do to help improve your urinary symptoms and ultimately improve your quality of life as a result,鈥� says Mitchell Goldenberg, MD, a urologist with 喵咪社区 Urology, part of 喵咪社区, who sees patients at .

Cause of urinary incontinence in women

Dr. Goldenberg treats two types of urinary incontinence often. Urgency incontinence, often associated with overactive bladder (OAB), refers to bladder muscles squeezing when they鈥檙e not supposed to. This creates an urge to suddenly urinate. The other type, stress incontinence, is usually due to weakened or uncoordinated pelvic floor muscles. Patients may experience leakage when they cough, laugh, sneeze or exercise.

Urinary incontinence happens to women more often than men because experiences like pregnancy, childbirth and menopause directly impact the muscles that control the bladder.

Incontinence is also more likely following bladder or uterine surgery. Smoking cigarettes and obesity are also risk factors.

Urinary incontinence treatments

There is no one-size-fits-all approach to treating urinary incontinence. 鈥淚 like to give my patients all the possible choices because everyone is different in how they experience and are affected by their symptoms,鈥� Dr. Goldenberg emphasizes.

Pelvic floor physical therapy

A pelvic floor physical therapy program typically begins with a full assessment including pelvic examination by a specially trained physical therapist who evaluates the strength, flexibility and coordination of the patient鈥檚 muscles. This initial examination allows the therapist to accurately understand which muscles need to be targeted to improve the patient鈥檚 urinary symptoms.

Pelvic floor physical therapy often involves muscle-strengthening exercises such as Kegels, Pilates, stretching and yoga. Therapists may also incorporate relaxation techniques such as biofeedback and mindfulness.

Dr. Goldenberg says patients who are committed to their program may see results in two to three months. 鈥淚 always tell patients they get out of it what they put into it,鈥� he explains. 鈥淚t鈥檚 like having a personal trainer at the gym. If you do the exercises only when you鈥檙e with the trainer, you probably won鈥檛 see results.鈥�

Pelvic floor physical therapy can give people the knowledge and skills they need to effectively manage symptoms for the rest of their lives, Dr. Goldenberg adds. 鈥淥ften, they can correct the underlying issues without needing more invasive treatments.鈥�

Urinary incontinence medication

Patients with urgency incontinence may benefit significantly from medications that relax the bladder muscles, Dr. Goldenberg says. This can allow patients to urinate less often and give them more time to get to the bathroom when they feel the need.

However, he says that for patients confirmed to have stress incontinence only, he doesn鈥檛 recommend medications. 鈥淭hose patients generally have issues with their pelvic floor muscles, and no medications are available to address these specific symptoms.鈥�

Botox treatment

Patients with urgency incontinence symptoms who don鈥檛 respond adequately to oral medication, or who simply prefer another alternative, can benefit from botulinum toxin injections 鈥� Botox (onabotulinumtoxin A) being the brand approved for bladder conditions.

Botox injections are administered in the doctor鈥檚 office and usually take only a few minutes. Like other medications, Botox helps the bladder relax and can provide more immediate relief for urgency incontinence symptoms. The effects typically last for around six months before another injection is needed.

Surgery for urinary incontinence

If urinary incontinence is severely limiting a person鈥檚 daily activities, they may prefer treatments that can provide more immediate results. 鈥淪urgery should not be thought of as a last resort,鈥� Dr. Goldenberg stresses. 鈥淣ot all leakage is the same, and surgery is a choice to be considered based on each patient鈥檚 unique circumstances.鈥�

One surgical option for patients with urgency incontinence is sacral neuromodulation, which has been shown to improve bladder control. A small device about the size of a pacemaker is implanted into the lower back. The device sends electrical pulses to the sacral nerves, which control the organs in the pelvic region.

For patients with stress incontinence symptoms, an option is urethral sling surgery. The provider inserts a sling, made of either synthetic material or the patient鈥檚 own tissue, to support the pelvic floor muscles.

A less invasive option is urethral bulking, which involves using an injection to narrow the urethra and make it harder for urine to leak out when not desired.

Finding the right urinary incontinence treatment for you

鈥淗owever you view your urinary symptoms, it is important to talk to your doctor about the pros and cons of the different treatment options available,鈥� Dr. Goldenberg says.

鈥淯rinary incontinence is so prevalent and can have such a big impact on someone鈥檚 quality of life,鈥� he continues. 鈥淒on鈥檛 hesitate to speak with your primary doctor, urologist or gynecologist about your symptoms and start discussing these often simple, yet highly effective, treatments.鈥�

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