Treating Urinary Incontinence

Treatment choices for urinary incontinence range from lifestyle changes to surgery. Your treatment will depend on the underlying problems causing the incontinence. But keep in mind that no treatment works perfectly, and you may have to try more than one approach before you find the one that best suits your needs (see "What to do for urinary incontinence," below). Treatments may be different for men and women. Because there are a variety of options, your preferences are important in developing a plan.

It's also important to know that less invasive treatments, such as biofeedback or pelvic floor exercises, are a good first step and can be helpful, but may not be as effective as some surgical procedures. Even surgical treatments are becoming less invasive and requiring shorter recovery times. You and your physician need to decide which is most appropriate for you. Check with your health plan to find out which therapies are covered. Treatment for urinary incontinence is an area of active research, and new approaches are under development.

Quick Guide: What to do for urinary incontinence

Lifestyle changes

• Bladder training (overactive bladder)

• Fluid management (overactive bladder and stress incontinence)

• Pelvic floor physical therapy (overactive bladder and stress incontinence)

• Biofeedback (overactive bladder and stress incontinence)

Muscle conditioning without exercise

• Electrical stimulation (overactive bladder and stress incontinence)

Medications

• Alpha-adrenergic agonists (stress incontinence)

• Anticholinergics (overactive bladder)

• Cholinergics (overflow incontinence)

• DDAVP (bedwetting)

• Tricyclic antidepressants (overactive bladder and nocturia)

• Alpha-adrenergic antagonists (for men, for overflow incontinence)

• Estrogen (for women, for overactive bladder and stress incontinence; evidence of efficacy is inconclusive)

Surgical procedures

• Sling, male and female versions (stress incontinence)

• Bladder neck suspension, Burch procedure, open or laparoscopic (stress incontinence)

• Artificial urinary sphincter (reflex and stress incontinence); rarely used in women

• Sacral neuromodulation (severe overactive bladder in men; overflow incontinence; incontinence related to overactive bladder, urinary retention, or frequency in women)

Other procedures

• Injection of bulking agents (stress incontinence)

• Percutaneous tibial nerve stimulation (overactive bladder)

• Injection of botulinum toxin (overactive bladder)