Treatment of all urinary incontinence should start with paying more attention to when the incontinence occurs. This can often be accomplished by use of a bladder diary. Stress incontinence can sometimes be improved with Kegel exercises and timed voiding. There are surgical options to treat stress incontinence when the above conservative measures are not effective. Surgery can be in the form of injecting material into the urethra to help the sphincter close off the urethra, or by placement of a sling or lifting the urethra, in order to assist in kinking off the urethra when you strain. Both of these treatment options are possible in men and women. Urge incontinence can be treated in a variety of ways, all looking to address what may be causing it. As alluded to above, there are a lot of reasons as to why urge incontinence occurs. Treatment can vary from diet modification, to medicine that can be taken daily, to stimulating the nerves that go to and from the bladder.
To make matters even more complicated, a large portion of the time, the above incontinence types occur together, which is given the generic name of mixed incontinence. This is why a full evaluation of the individual is necessary, including a look in the bladder with a scope(cystoscopy), a genitourinary examination, and oftentimes a procedure called urodynamics. These examinations and procedures, along with a collection of information from the patient, helps the health care provider to determine how best to address the incontinence. It also is necessary in order to rule out other causes of incontinence, such as cancers, neurologic disease, etc.Finally, there is overflow incontinence which is really just a manifestation of the bladder not emptying well. This is typically because of either an obstruction, such as a large prostate, or an inability of the bladder to squeeze appropriately. Treatment can vary from resection of the obstructing item, for example the prostate, or further evaluation as to the cause behind why the bladder won’t squeeze. This latter scenario has been given the name of an “underactive bladder” and urologists across the country have been working to bring attention to this very prevalent problem which has historically been ignored.