Stress incontinence occurs when women leak urine
resulting from coughing, sneezing, laughing, exercising or
intercourse. This form of incontinence affects about half of the
women living with incontinence, making them afraid to engage in
their normal physical activities because of increased problems
during exercise. Genuine stress incontinence is the leaking of urine
during increased abdominal pressure even without bladder
contractions. It is the most prevalent form of urinary incontinence
among women. The second most common form is detrusor instability, or
Urge incontinence is associated with a
heightened urgency and frequency of urination. Most of the women
diagnosed with this form of urinary incontinence, feel the urge to
urinate, but rarely make it into the restroom in time. Women with
this type of incontinence appear to have involuntary or
uncontrollable bladder contractions, even in the absence of damage
to their lower pelvic nerve. There are non-surgical and surgical
treatment options for all three forms of urinary incontinence.
Before you or your doctor decides the kind of
incontinency you are dealing with, the doctor will have to isolate
exactly which kind is being experienced: urge incontinence or stress
incontinence. Most doctors feel that incontinence can be cured or
controlled at least 80 percent of the time. The most important step
is finding the correct treatment that will work best with a person’s
lifestyle. A variety of new treatment options for women has been
developed to treat urinary incontinence such as biofeedback, FemSoft
Insert, Neocontrol, tension-free transvaginal tape (TVT) and
Biofeedback or electromyography is used to
collect information about the tone or condition of muscles
located in the pelvic floor through the use of sensors attached
to a monitor. These muscles help control urination and can be
strengthened through Kegel exercises, which involve contracting
the pelvic floor muscles for a few seconds and repeating the
exercise several times a day. Biofeedback is a non-chemical and
non-surgical treatment option for urinary incontinence.
The FemSoft insert is a single-use
disposable product designed to prevent leakage of urine in women
suffering from stress urinary incontinence,” according to
Rochester Medical Corporation. The insert is a soft sleeve
filled with a thin fluid that is inserted into a woman’s
urethral tract. It conforms to the woman’s natural shape and
prevents leakage of urine, even during increased physical
activity. The FemSoft inserts are an extremely new edition to
treatment options, as well as NeoControl.
A device known as the NeoControl is one of
the latest therapies to treat urinary incontinence for women.
This treatment includes fitting an office chair with magnets in
its seat in order to create a pulsing magnetic field which
strengthens the pelvic floor muscles. The Food and Drug
Administration approved it for treatment of all forms of
incontinence in women. In a study of 83 women, NeoControl has
successfully reduced incidences of urinary leakage in women with
stress incontinence from 3.3 to 1.7 daily according to
researchers at Emory University. Another effective procedure is
tension-free transvaginal tape (TVT).
Tension-free transvaginal tape is a surgical
procedure that requires a surgeon to insert a synthetic tape
between a woman’s abdominal and vaginal wall. In less than six
weeks, tissue will have grown around the tape to hold it in
place to support the neck of the bladder. There is a possibility
with this procedure that the tape will be expelled from the body
due to rejection from infection or tissue perforation. Some
women prefer not to have surgery to correct their urinary
incontinence and would rather take the many oral medications
which are available to them today.
Other Treatments for Urinary
Behavior Therapies: For those who suffer
from stress urinary incontinence, behavior therapy can be a
treatment option. Techniques can teach you to control your
bladder and sphincter muscles by:
Decreasing fluid intake
Prompting or scheduling voiding (used in
women who can recognize some degree of bladder fullness)
Pelvic muscle exercises: These exercises are
commonly called Kegel exercises and are used to strengthen the
weak muscles surrounding the bladder.
Protective Undergarments: Products such as
pads, undergarment liners and absorbent underwear are worn to
absorb urine that has leaked from the bladder.
Catheter: Some women require an indwelling
catheter, which is left in place 24 hours a day to continually
collect urine in an external drainage bag.
External Devices: Some women with urinary
incontinence use a pessary device, a stiff ring that is inserted
into the vagina where it presses against the wall of the vagina
and the urethra. The pressure helps reposition the urethra,
Bulking Injections: A bulk-producing agent,
such as collagen, is injected to bulk up the urethral lining so
the urethra can close more tightly.
Medication: A number of medications can help
bladder control problems due to urge incontinence. However,
there are presently no medicines currently available to treat
stress incontinence. If your doctor determines you have mixed
(stress and urge) incontinence, you may find drug therapy
helpful in addressing the urge component of your incontinence.
Surgery: There are surgical options to treat
urinary incontinence. These include:
Retropubic Suspensions: These surgical
options treat hypermobility and often are referred to as the
Burch procedure. They elevate and restore the urethra and
bladder neck to a higher anatomical position.
Slings: A sling procedure is used to treat
both hyper-mobility and ISD. The sling serves as support for the
urethra during increased abdominal pressure.
Bone fixated slings treat incontinence by
supporting the urethra with a graft material that is secured to
the pubic bone, such as the AMS In-Fast Ultra.
Self-fixating slings treat incontinence by
supporting the urethra. The sling is secured in place by
friction and natural tissue in-growth, rather than by sutures or
Today, there are more treatments for urinary
incontinence than ever before. They range from simple and safe, to
complex and risky. The simplest and safest should always be the
first to try. Often, a combination of treatments is used.
The treatment of urinary incontinence depends on
the type and severity of the problem, lifestyle and of course
personal preferences. Whatever the case, you should seek a
professional opinion, be aware of all the options and actively
participate in the decision process. The treatments range from
simple and safe, to complex and risky. The simplest and safest
should always be the first to try. Often, a combination of
treatments is used. Just know you are not alone, and that there are
many different things you can try in order to alleviate or
completely do away with urinary incontinence.