If you’re dealing with incontinence, you may think your only solution is an uncomfortable, anything-but-discreet adult diaper. But that’s far from the case. There are dozens of options to help, from lifestyle changes to procedures to surgery, says Alexander Schwartz, M.D., a urologist at Pascack Valley Medical Center. “In fact, I would almost say that adult underwear is the last choice,” says Dr. Schwartz.

So how can you treat the leak? Here is a range of options.

Lifestyle Changes 

Monitor your liquid intake. If you’ve experienced accidents, your first reaction may be to cut down fluids. But drinking too little can lead to highly concentrated urine, which can irritate your bladder and cause you to go more often. Instead, drink small amounts steadily throughout the day and stop drinking about two to three hours before bed.
Investigate what you eat and drink. Certain foods and beverages can irritate the bladder, making it spasm so you feel the urge more often. Common irritants include citrus fruits, spicy foods, tomato-based products, artificial sweeteners, caffeine, alcohol and carbonated drinks, says Dr. Schwartz. Try eliminating possible culprits, then gradually add items back one at a time and monitor how you feel.

Practice pelvic floor therapy. This can benefit both men and women. Kegels (squeezing the pelvic floor muscles) help strengthen the muscles that support the urethra. They also help rewire communication between the brain and bladder. “When you do a Kegel, it sends a message to the area to relax until you have time to get to a bathroom,” says Dr. Schwartz.

Watch your weight. The more you weigh, the more pressure is placed on your bladder, which can prompt the urge to go before the bladder is completely full.

Medications

Antispasmodics. These are the most widely used medicines for incontinence, says Dr. Schwartz. They work by blocking the nerve receptors on the muscles in the bladder. Unfortunately, they can sometimes cause side effects like dry mouth, blurry vision and constipation. Another option is a patch, which can be worn for four days at a time and may not cause the same side effects.

Tricyclic antidepressants. While only used in occasional cases, these can calm nerve signals and decrease bladder contractions.

Prostate medications. If incontinence is caused by an enlarged prostate, medication to treat the prostate can be used.

Devices

A pessary. For women, this ring-like device, which must be fitted by a doctor, can be inserted into the vagina to lift and support the vagina and bladder.

A urethral clamp. Men can place these temporary devices around the penis to put light pressure on the urethra and block the flow of urine.

Procedures

Botox. A doctor uses a small camera to see inside the wall of the bladder and injects the medicine, which causes the muscles in the bladder to relax. Results aren’t permanent and should be redone about every six months. 

Bladder pacemaker. This implantable device sends painless electrical impulses to the nerve fibers that regulate the muscle of the bladder. Placement is done on an outpatient basis, under local anesthesia.

Midurethral sling. In this procedure designed mainly for women, a surgeon places a sling made with a narrow strip of synthetic mesh under the urethra, which acts like a hammock to support the urethra and bladder neck. It’s most commonly done as an outpatient procedure, using local or general anesthesia.

Artificial urinary sphincter. This cuff is placed around a man’s urethra to help keep it closed and prevent leaks. It’s most commonly done on an outpatient basis and uses local or general anesthesia.

Next Steps & Resources:

• Meet our source: Alexander Schwartz, M.D.
• To make an appointment with Dr. Schwartz or a urologist near you, call 800-822-8905 or visit our website.
  
  

The material provided through HealthU is intended to be used as general information only and should not replace the advice of your physician. Always consult your physician for individual care.