Nonsurgical Treatment of Urinary Incontinence

There are three types of urinary incontinence: stress urinary incontinence (SUI), urgency urinary incontinence (UUI) and mixed urinary incontinence (MUI). Stress urinary incontinence occurs when there is a physical stressor such as coughing, sneezing, running or exercise. Urgency urinary incontinence is when one experiences a strong urgency to urinate and is not able to defer or wait until she gets to the restroom. Mixed urinary incontinence is when there is both SUI and UUI.

Treatment depends on the severity of the symptoms and if there are secondary complications such as the need for pad use, vaginal irritation, urinary tract infections and an overall decrease in one’s quality of life due to symptoms.

Nonsurgical treatment of SUI may include kegel exercises, InTone, pelvic floor physical therapy or even a wait and watch approach if symptoms are rare or minimally bothersome. If SUI becomes disruptive to the point that the sound of surgery is better the symptoms, we recommend a mid-urethral sling which is the gold standard for treatment of SUI. This is typically a 30 minute outpatient procedure with minimal recovery time.

Nonsurgical treatment of UUI is more common and may include bladder retraining, InTone or medications. InterStim or Botox bladder injections may be indicated for refractory UUI or UUI that does not respond to nonsurgical treatment.

In the case of MUI, treatment depends on if SUI or UUI is more disruptive. The more disruptive type of incontinence is usually targeted first and then symptoms are re-evaluated. Urodynamics (a study done to assess how the bladder is functioning) may be recommended prior to initiation of treatment for urinary incontinence.