Incontinence Treatment

The treatment will depend on the type of incontinence you have. Sometimes working this out can be really challenging and it can take some trial and error to find something that works for you. Don’t give up if your leaks don’t improve at first, it’s worth trying a few things.

Pelvic floor exercises -Pelvic floor exercises are well researched and have been shown to improve both bladder and bowel leaks. They are especially effective for stress incontinence. Pelvic floor exercises have many other benefits and it is worth incorporating these into your weekly routine anyway. If you have been trying pelvic floor exercises and they haven’t changed your incontinence it is worth getting your pelvic floor muscles assessed by a pelvic health physiotherapist. They will help you to work out if you are doing the exercises right, if you need to work on something more specific or if your pelvic floor is already functioning well.

If you need more help with your pelvic floor exercises or reminders try these resources:

Know Your Floors - Know Your Floors for fun pelvic floor exercises and educational videos

Squeezy App – pelvic floor reminders

Bladder and bowel retraining or timed voiding– These techniques can be used to help improve urgency and leaks by training them to be better at holding or by going more often. A bladder or bowel diary will be used to help decide on the type of approach that might be best.

Bladder and bowel habits – Exploring this can have huge benefits and includes a variety of things like optimising your diet and fluid intake, modifying the use of bladder irritants such as caffeine, fizzy drinks and alcohol, and looking at toileting techniques and things that might trigger your leaks.

Specialist care – You may be referred to a Specialist Service if your condition is complex or linked to a certain condition. These services often have a mix of health professionals who will tailor your treatment to your individual needs.

Medications – there are many medications that can help with both bladder and bowel leaks. There are also medications that might increase your likelihood of leaking. If you are on lots of medications it would be useful to ask your doctor if any of these may worsen leaks. Vaginal oestrogen may also be useful for some incontinence symptoms in women who are menopausal or have low levels of oestrogen. Medications may have other side-effects so make sure you talk to your doctor about what might be right for you.

Nerve stimulators – A sacral nerve stimulator can be fitted surgically. There are also nerve stimulators that can be used over the skin, however the evidence-base for these is not as good. You might want to consider this if other low-risk options have not worked and you are not as keen on invasive procedures.

Botox – this can be used in severe cases of an overactive bladder. Botox is injected into the bladder to reduce over activity of the muscle. You will be taught how to catheterise as in some cases the bladder can stop working for a period of time. The effects of botox wear off over time, but if it has been beneficial it can be repeated.

Surgery – There are surgical options for incontinence, but not for all types of incontinence. As surgery is more invasive and has additional risks it is usually offered only when all other options have failed and incontinence is significantly impacting your life.