There are many different ways of coping with urinary incontinence. Seek help if your symptoms bother you: consult your family doctor, general practitioner, or urologist. It may be uncomfortable to discuss your condition with a doctor, but it is the most effective way to deal with your concerns.
Treatment for urinary incontinence depends on the type of incontinence, how severe it is, and what may cause it. There is no single solution to incontinence that works for everyone. Discuss with your doctor or specialist nurse which measures can help you. It is common to try different options to figure out which one works best for you.
Sometimes, conservative measures can significantly improve your condition and lead to a better quality of life. These measures include lifestyle changes, bladder training, and pelvic floor muscle exercises. Other treatment options, such as medication and surgery, should be considered if conservative management is ineffective.
Surgical treatment for urinary incontinence
Sometimes conservative or pharmacological treatments do not improve your urinary incontinence. In these cases, other treatment options are available. Together with your doctor, you can decide which approach is best for you and the expected benefits and side effects you can expect with every one of the different options.
Surgical treatment options for urgency urinary incontinence are:
- Nerve stimulation (neuromodulation): electrical pulses to stimulate the sacral nerves, which control the bladder behavior.
- Surgery to increase bladder volume. This represents the last choice, only when all other treatments have failed, rarely performed nowadays. If this surgery is recommended, you will need to discuss its implications and side effects with your doctor because they can be significant.
Surgical treatment options for stress urinary incontinence:
- Suburethral slings: sling placed under your urethra.
- Bulking agents: a substance injected into your urethra to increase its resistance.
- External compression devices: devices that compress your urethra to avoid leakage.
Second-line treatment for urgency urinary incontinence
Sometimes self-management or the drugs your doctor prescribed do not improve your urgency urinary incontinence (UUI). In these cases, other treatment options are available. Together with your doctor, you can decide which approach is best for you.
Standard second-line treatment options for UUI are:
- Nerve stimulation, also known as neuromodulation
- Surgery to increase bladder volume
Bladder surgery
If your symptoms have not improved with drugs or other treatments, you may need surgery on your bladder. The goal of the procedure is to increase the capacity of the bladder. This will reduce the pressure in the bladder as it fills so that it can hold more urine.
The doctor makes an incision in your lower abdomen and uses a piece of your bowel to increase the size of the bladder. This procedure is called bladder augmentation or cystoplasty and is rarely performed nowadays (Fig. 3). If this surgery is recommended, you will need to discuss its implications and side effects with your doctor because they can be significant.
Click on the relevant treatment option below for more information:
