Urinary Incontinence

Urinary Incontinence Care at Beth Israel Deaconess Hospital–Needham

Urinary incontinence — the involuntary leakage of urine — is common and distressing and almost always results from a treatable underlying condition. The severity ranges from occasionally leaking when you cough or sneeze to an urge so sudden and strong that you can’t get to a bathroom in time.

Urinary incontinence is especially common in older men and women, nursing home residents and people who are obese.

Urinary Incontinence Treatment

The treatment of urinary incontinence depends on the type and severity. Doctors, however, recommend these least invasive treatments first:

• Bladder training: Learning to delay urination and lengthen the time between bathroom trips.
• Fluid and diet management: Modification of eating and drinking habits to regain control of the bladder.
• Pelvic floor exercises: With the goals of strengthening the urinary sphincter and pelvic floor muscles, these Kegel exercises include squeezing the muscles used to stop urination.
• Scheduled toilet trip: Timed urination.

In many cases, simple lifestyle changes or medical treatment can stop urinary incontinence. If these more conservative treatments are not enough to manage your urinary incontinence, your urologist may recommend that you try one of these options:

• Medications:
  • Anti-cholinergic (nerve-blocking) drugs to calm an overactive bladder.
  • Certain antidepressant drugs to treat stress and mixed incontinence.
  • Low-dose topical estrogen to rejuvenate the urethra and vaginal area.
• Sacral neuromodulation procedure: A technique to improve nerve function related to urination.
• Surgery: When other treatments are not enough, surgery may be an option, ranging from minimally invasive injections of bulking agents to major surgical intervention.

Female Urinary Incontinence Treatments

There are a variety of ways to treat female incontinence with or without pelvic prolapse. New medications are on the horizon and minimally invasive treatments are currently available.

Our urologists are experts in a variety of treatments:

• Artificial urinary sphincter: To keep urine from leaking
• Bladder neck suspension procedure: Connecting the bladder neck, part of the vaginal wall and urethra to the bones and ligaments of the pelvis so the urethra and bladder can close better
• Periurethral bulking agents (collagen and durasphere): Helps to prevent leaking of urine from the urethra
• Sling procedure: Controls stress incontinence through better supporting the urethra