Women’s Health Care Resources

Typically, treatment options start from the least invasive and progress to more invasive options in order to adequately control symptoms. Your exact treatment plan depends on the type of incontinence you have and how severe your symptoms are.

Lifestyle Changes

Various lifestyle changes may help alleviate urinary incontinence. Numerous studies show that weight loss and physical activity can greatly reduce bladder leakage. Additionally, some foods and beverages may aggravate urinary incontinence, including:

• alcoholic beverages
• carbonated beverages
• coffee and tea
• spicy foods
• tomato-based foods
• citrus foods or juices
• artificial sweetener
• chocolate
• sugar
• honey

Bladder Training

Bladder training involves learning to delay urination after you get the urge to go. You may start by going to the bathroom and trying to pass urine every two hours while you are awake. The goal is to lengthen the time between trips to the toilet until you’re urinating every two to four hours. You will need to try to pass urine at the scheduled time, even if you do not feel the urge to go. Bladder training also involves learning to control urges to urinate. When you feel the urge to urinate before your scheduled time, you should relax, sit down or stand still, breathe slowly and deeply and focus on making the urge decrease or go away.

When you feel in control of your bladder, you should walk to the bathroom and urinate. By practicing this consistently, you can slowly increase the time between scheduled trips to the toilet. This can be very discouraging but is often very effective if practiced diligently.

Kegel Exercises

Kegel exercises strengthen the pelvic floor muscles, which support the uterus, bladder, and rectum. The pelvic floor is a “hammock” of muscles from the pubic bone in front to the tailbone in the back that hold the pelvic organs in place. You can do Kegel exercises just about any time. As you are sitting or lying down, try to contract the muscles you would use to stop urinating. You should feel your pelvic muscles squeezing your urethra and anus. If your stomach or buttock muscles tighten, you are not exercising the right muscles. When you’ve found the right way to contract the pelvic floor muscles, squeeze for 3 seconds and then relax for 3 seconds. Repeat this exercise 10 to 15 times per session. Try to do this at least 3 times a day.

Kegel exercises are only effective when done regularly. The more you exercise, the more likely it is that the exercises will help. These exercises can be done alone or along with biofeedback.

Biofeedback

Biofeedback has been shown to be an effective treatment option for urinary incontinence. It can be used to help women learn to control and strengthen the pelvic floor muscles. The pelvic floor muscles are a group of muscles that play an important role in bladder control. Weakness or dysfunction of the pelvic floor muscles can lead to problems with bladder support and control.

Because you cannot see the pelvic floor muscles, you may find it difficult to locate them. You may be unsure if you are doing the pelvic muscle exercises correctly. This is where biofeedback comes in. Biofeedback therapy uses computer graphs and audible tones to show you the muscles you are exercising. It also allows the therapist to measure your muscle strength and individualize your exercise program. It does not do anything to your muscles but is used as a teaching tool to help you learn to control and strengthen the pelvic floor area.

Two small sensors are placed on either side of your anus, where the pelvic floor muscles are close to the skin. These can be placed under your loose clothing. Another set of sensors is placed across the abdomen. The sensors around the anus are connected to a computer screen and display a graph of your muscles as they are being exercised.

Since many women incorrectly use their stomach muscles when doing pelvic floor exercises, the sensors on the abdomen display a computerized graph to show you when you are using these muscles instead of those on the pelvic floor. The graphs also are helpful in measuring your growth in strength between biofeedback visits. The duration and frequency of these visits is individualized to each patient.

Pelvic Floor Physical Therapy

Pelvic floor physical therapy is a type of therapy that focuses on the muscles of the pelvic floor. Pelvic floor physical therapy for urinary incontinence involves the therapeutic manipulation and strengthening of tissues and muscles to improve bladder control. This specialized technique utilizes both internal (transvaginal and/or transrectal) and external stretching and massage techniques to improve muscle and tissue function along the floor of the pelvis. It is performed by specialized physical therapists in an outpatient office. We refer our patients to the pelvic floor specialists at Waukesha Memorial Hospital.

In many cases, patients and their partners may be taught these techniques so that they can be performed more frequently at home.

Pessary

A pessary is a disc-like device that is inserted into the vagina to help with pelvic floor disorders and stress urinary incontinence. These devices are fit to your body and help lift the bladder and surrounding pelvic organs. Your provider will size you in the office to ensure a proper fit. Typically, you can insert and remove this on your own as needed.

Medication

There are various types of medications used to treat urinary incontinence if behavioral methods are ineffective.

Other Options

BOTOX® injections can help relax the bladder to treat some types of urinary incontinence, including overactive bladder.

Sacral nerve stimulation uses a small implanted device that delivers gentle electrical impulses to a nerve in your lower back that controls the bladder. This device can help improve bladder function.