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Treatments

Depending on the cause and severity of incontinence, treatment may be surgical or non-surgical.

The following nonsurgical techniques can be effective:

  • Bladder training, or urinating according to a timetable (instead of according to urge)
  • Biofeedback and electrical stimulation, which interrupts the nerve signals to the bladder
  • Kegel or pelvic floor exercises, which strengthen pelvic muscles
  • Dietary changes, to avoid foods that trigger your symptoms
  • Medications to improve bladder control
  • A pessary, which is a device inserted into the vagina to help support the bladder, rectum, or uterus

Surgical options

For some women, surgery may be the best option. Many operations are minimally invasive.

  • The mid-urethral slings are several new procedures that require only very small incisions at the vagina and above the pelvic bone or in the groin. Permanent mesh tape is placed through the incision at the bladder outlet.
  • Abdominal bladder suspension (Burch procedure) repositions the bladder and urethra to give them more support behind the pubic bone. Your doctor would go in through a small abdominal incision and provide support with sutures (stitches). You may spend a few days in the hospital. Complete healing takes about six weeks.
  • Laparoscopic Burch suspension is a similar procedure, but uses less invasive tools. It may be possible to do this procedure on an outpatient basis. Most healing is done within ten days; do not lift heavy objects for about six weeks.
  • Bulking agents are outpatient injections of material (collagen or another type of material) at the bladder neck, used to help close the bladder outlet.
  • A pubovaginal sling is a combined vaginal and abdominal procedure that uses a strip from the abdominal wall and passes it under the bladder neck.
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