When it comes to SUI, the majority of women can be treated successfully and resume a full and active lifestyle. In most cases, your doctor will start with less invasive treatments such as physical therapy and lifestyle and behavioral modifications. Medical devices or surgery may be recommended if these treatments do not adequately help your bladder control symptoms.
First Line Treatments
The goal of physical therapy for treating stress incontinence symptoms is to
strengthen the pelvic floor muscles so that you can control urine output during everyday activities. Your physical therapist will perform a comprehensive
internal and external exam of the pelvic floor muscles.
- Pelvic Floor Muscle Exercises – Pelvic floor exercises can help prevent urine leakage by strengthening the pelvic floor and sphincter muscles. Your physical therapist will show you how to perform these exercises to promote muscle strengthening, relaxation and coordination. Biofeedback can help determine if you are exercising the proper pelvic muscles.
Fluid and diet management
Changing the amount and timing of fluid intake during the day, as well as avoiding common dietary irritants such as caffeine and tomato-based foods, may help bladder function.
Healthy lifestyle changes
Losing excess weight and quitting smoking (which leads to chronic cough) can help eliminate some of the pressure on your bladder.
Absorbent incontinence pads
Sometimes, treatments are not 100% effective and women with mild urine leakage may want to use absorbent pads for added protection.
Primary Surgical Treatment Options for SUI
Urethral slings are the most common and effective surgical treatment option for SUI. Your doctor will perform a minimally invasive procedure to place a sling, a small piece of synthetic mesh, under the urethra. The sling forms a hammock of support for your urethra, keeping it supported to eliminate accidental urine leakage.
Placement of the urethral sling is done as an outpatient procedure and only requires a small incision in the vagina. You can expect to go home a few hours after the procedure. Most women do not experience major pain or discomfort after the placement. You can return to light activity four to six weeks post-surgery; however, you should avoid heavy lifting, sexual intercourse and rigorous exercise for four to six weeks following your procedure. You doctor will discuss post-operative instructions with you.
- A minimally invasive outpatient procedure
- An effective treatment for SUI for more than 30 years
- Many women see immediate results following placement of the sling
- Covered by most major medical insurance
- General risks associated with surgery
- Serious complications are very rare but can include trouble with urination following the procedure, a reaction to the sling material, or return to incontinence
Urethral bulking involves the injection of a special material called a bulking agent around the urethra. Your doctor can perform this minimally invasive procedure under local anesthesia in the office or in an outpatient surgical center. The bulking agent helps build up the thickness of the urethral wall to support the bladder and form a tight seal to prevent urine leakage. Using a periurethral or transurethral approach, your doctor will inject the bulking material into the area around the urethra.
- No incisions
- Quick procedure with minimal side effects
- Short recovery time
- May not work for some women
- Not a permanent treatment; may need to be repeated over the course of months to years