Female urinary incontinence (UI) can be uncomfortable and sometimes embarrassing, and as a result women often suffer for too long with this highly treatable condition. There are a wide variety of effective treatments available, which one your doctor recommends will depend on the cause of your UI and the severity of your symptoms.

Diagnosing Female Urinary Incontinence

Treatment starts with identifying the type of female incontinence that you have. To diagnose your condition, your doctor will take a thorough medical history and physical exam. Sometimes keeping a voiding diary will help your doctor better define your voiding issues. Your doctor may also recommend a urinalysis and urine culture, a bladder stress test, an ultrasound, cystoscopy, or urodynamics to evaluate the scope and type of UI you are experiencing.

Diagnosis of pelvic organ prolapse is appropriate during the UI evaluation process as well.

Treatments for Female Urinary Incontinence

There are many treatment options available to treat your UI:

Behavioral Treatments such as Kegel exercises can be very effective in building up strength in the muscles that help hold in urine. A voiding diary can help your doctor see patterns in your voiding behavior. Your doctor may also recommend scheduling times for urination (timed voiding) in order to help you gain control of your bladder. Once you’ve gained control of your bladder, you can extend the time needed between bathroom trips. A reduction in liquid intake and caffeine can also reduce urine output and help alleviate symptoms of UI.

Medication is prescribed according the type of UI you are experiencing. Women who experience overactive bladder may benefit from anticholinergic medications which help relax bladder muscles and prevent bladder spasms.

Biofeedback helps women regain control of their bladder muscles by providing feedback about their bladder activity. Feedback is generated using electrodes to record when bladder and urethral muscles contract. Biofeedback can be used in conjunction with Kegel exercises and electrical stimulation to treat stress and urge incontinence.

A pessary device is stiff ring which is inserted into the vagina and is used to reposition the urethra. The pessary presses against the walls of the vagina which increases pressure on the urethra, lessening the leakage associated with stress incontinence.

Injections of bulking materials which thicken the bladder neck may help close the bladder opening and alleviate stress incontinence. It will take your doctor about a half an hour to inject the bulking agents into tissues around the bladder neck and urethra. Injections are administered under local anesthesia.Urinary catheterization is a procedure in which a urinary catheter (a thin tube) is inserted through the urethra into the bladder to drain urine. Catheterization helps women who are unable to empty their bladder due to muscle weakness, previous surgery, or injury. Catheter can be left in place long-term, or re-inserted four to six times a day.

Surgical Treatments for Female Incontinence

Some women experience a shifting of their bladder out of its normal position, especially after childbirth. Surgery can reposition the bladder into a normal position and alleviate symptoms of UI.

Retropubic suspension uses sutures (surgical threads) to support the bladder neck at a normal position. The most common retropubic suspension procedure is the Burch colposuspension. To perform the Burch colposuspension, your doctor accesses your pelvis through an incision in your abdomen. Strong threads are secured to strong ligaments within the pelvis, helping to reposition the bladder by supporting the bladder neck.

Sling procedures support the bladder at a normal position by cradling the bladder neck with a “sling.” The surgeon inserts the sling through an incision through the vagina. Traditional sling procedure uses a sling made from a strip of your own tissue (fascia) or from man-made material. The sling is attached to the pubic bone or just above the pubic bone.

A midurethral sling is a newer procedure where the sling is attached midway along the urethra. Your doctor makes a small incision in the vagina, as well as small incisions behind the pubic bone or sides of the vaginal opening. Using special needles to thread synthetic tape under the urethra, your doctor will pull and adjust the tape through the incisions until the right amount of support is generated.

Neuromodulation/InterStim is used to stimulate the nerves from the spine to the bladder through an FDA-approved device called InterStim. When urge incontinence does not respond to behavioral treatments or medication, your doctor may recommend this approach.

If you suffer from pelvic prolapse, your doctor may recommend prolapse repair surgery or a hysterectomy in addition to UI alleviating surgery.

Speak with your doctor about the best treatments to alleviate your urinary incontinence.