Urinary Incontinence: Self-Care Treatment Options

There are several therapies which can be performed by the patient.

Kegel exercises are usually recommended, and can be very effective in women. Patients should be instructed on how to find the right muscles and technique. A general recommendation is to do three sets (10-15 repetitions) of Kegels daily. It takes a a while to see results, but a patient can expect to see some results within a few weeks to a few months from the start of their routine.

Other components of bladder training include delayed urination and scheduled bathroom trips.

The recommendation for delayed urination is to try to hold urine for about 5 minutes when an urge is felt, increasing this to 10 minutes when it becomes easier to delay. This delayed urination can help to build the habit of urinating every three to four hours.

Scheduling bathroom trips means setting times to go to the bathroom whether or not an urge is present. At first, the schedule may include going to the bathroom hourly with gradual increases to every three to four hours. Bladder training generally requires about 3 to 12 weeks to get results.

For overweight patients, changes in diet combined with losing weight can improve stress incontinence episodes. Also, have your patient avoid foods and beverages that can irritate the bladder, like alcohol, caffeine, and spicy foods. Reducing fluid intake a few hours before bed can also help to reduce nighttime incontinence.

And, of course, smoking cessation is also recommended.

Urinary Incontinence: Medical Treatment Options

Medications may be recommended for urge and mixed incontinence. These include topical estrogen, an estrogen-containing ring, or a patch for menopause-related low estrogen levels can all help. Other medications include bladder muscle relaxers, such as mirabegron, or even botox. And anti-cholinergic medications, such as oxybutynin, can help to reduce abnormal bladder contractions. Some anti-depressants may also be used, and it’s a good idea for the healthcare team to check the patient’s medications for any that are known to cause urinary incontinence.

There are some devices which can help as well. A vaginal pessary is a soft removable device that supports areas that may be affected by pelvic organ prolapse. The ring is another device that is quite common. It can be inserted and removed by the patient. There are other pessaries as well.

And injectable bulking agents, such as bovine collagen, and stem cells injections have been used with varying results.

Sacral neuromodulation involves a small subcutaneous electrical device that is inserted into the lower back that is fairly effective.

Surgical options may be appropriate in cases of severe stress incontinence or overactive bladder. Most options are either sling procedures or bladder neck suspension procedures.