Behavioral Treatments

• Six behavioral treatments may help control urinary incontinence. They are scheduled voiding, double voiding, bladder retraining, fluid restriction, pelvic muscle rehabilitation, and biofeedback.
  
  One of the easiest behavioral treatments to use is scheduled voiding. With scheduled voiding, you simply urinate on a schedule every two to four hours. The goal is to keep the bladder empty, which will help prevent wetness.
  
  Double voiding is another easy treatment to try. With this method you urinate whenever you need to, remaining in the bathroom to urinate again. This helps ensure that your bladder is emptied.
  
  If you are having problems with leakage, try reducing the amount of fluid you take in to four or five glasses a day. This will reduce the amount of fluid you have in your bladder and may help control leakage.
  
  Pelvic muscle rehabilitation uses exercises to help strengthen the muscles that control the bladder. The movements are called Kegel exercises. To do this, simply begin to urinate, then use your muscles to stop the flow. Once you learn the exercise you can do it several times a day. Over a period of six to eight weeks your muscles will get stronger, which may lead to a reduction in leakage.
  
  Biofeedback is another method used to strengthen the muscles surrounding the bladder. You hear a sound or see a bright light and in response train your muscles to tighten, thus controlling the bladder.
  
  

Medical Treatments

• Surgery and medications are two types of medical treatments used to control the condition.
  
  If you have urge incontinence, medications are often the first choice of treatment. These include anticholinergic medications and antidepressants.
  
  Anticholinergic medications include Detrol and Ditropan. Detrol is usually started with 1 to 2 mg two times a day. Ditropan is usually started with 5 mg two to three times per day. Tofranil, an antidepressant, is also used to treat urinary incontinence. The starting dosage is typically 25 mg at bedtime.
  
  If other treatments fail, surgery may be necessary. Six surgical methods are commonly used.
  
  The first two types of surgery are called retropubic suspension and transvaginal needle suspension. These methods involve the placement of stitches in the tissues surrounding the urethra.
  
  Another type of surgery that has gained popularity is the pubovaginal sling. In this method, a sling is placed under the neck of the bladder. According to Cornell University, this method has a 95 percent long-term success rate.
  
  Artificial urinary sphincters are used in men who have urinary incontinence after prostate surgery. This method involves the use of a sphincter controlled by the patient. This ensures that urine stays within the bladder until it is released by use of a pump.
  
  Sacral nerve stimulation is a new surgical treatment that stimulates the nerves controlling the bladder.