Treatment options include:
1. Bladder training >> This approach teaches you to urinate only at scheduled times and waiting longer between trips to the bathroom. Start by going to the bathroom every 30 to 60 minutes while you are awake, even if you don’t have to go. After about one week, slowly increase the time interval by 30 minutes every week.
2. Kegel exercises >> Dr. Arnold Kegel, a gynecologist at the University of Southern California, developed the exercises to strengthen pelvic floor muscles in 1948. Kegel exercises are often the first line of treatment for the millions of women in the U.S. suffering from unexpected bladder leakage due to coughing, sneezing, laughing or exercise. This if defined as stress incontinence but many women experience frustration because they unknowingly don’t perform the Kegels effectively, which leads to no improvement in symptoms. Most men or women need to do the exercises for 3-6 months before any changes will occur.
3. Pelvic Floor Electrical Stimulation with Biofeedback Therapy >> This treatment uses computer graphs and sounds you can hear to show you which muscles you are exercising so you can perfect the exercises. Physical therapists and other professionals specially trained in problems related to women’s health teach exercises for the pelvic floor, trunk, back and extremities that can help strengthen the pelvic muscles and improve bladder control. The physical therapist may use devices that use mild, comfortable, electrical stimulation to train the bladder muscles when and how to squeeze.
4. InTone is a new FDA listed Class II Medical Device for home use that has been shown to effectively strengthen the pelvic floormuscles and helps to prevent embarrassing leakage without surgery or medication and can be done in the privacy of home. InTone is like a personal trainer for Kegel exercises.
5. Medications >> Estrogen can be very helpful in improving the symptoms of some cases of incontinence. Studies have demonstrated improvement in 40- 70 percent of women. I have found that estrogen cream (one fourth to half an applicator) works better than either tablets or patches for this particular problem. Medications called smooth muscle relaxants (examples are oxybutynin and tolterodine) can also help if the problem is caused by abnormal bladder contractions.
6. Pessaries >> These donut-like plastic or rubber rings are similar to a diaphragm used for birth control. They are fit into the vagina to lift and offer added support for the bladder when the pelvic muscles are weak.
7. Surgery >> There are many operations that have been developed to support the bladder and improve or correct incontinence. Women don’t need to have a hysterectomy in order to control urinary incontinence. Most of these operations for incontinence can be performed as one-day surgeries.
8. Botox>> If you don’t respond to oral medications, you may be a candidate for Botox injections directly into the bladder muscle. This, too, can be done as a one-day stay procedure and usually produces relief of symptoms of frequency of urination and urgency of urination with urge incontinence
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