Treatments for Bladder Control Problems (Urinary Incontinence)

How can I treat my bladder control problem?

Treatment depends on the type of UI you have. Your doctor may recommend you first try self-care treatments.

Make lifestyle changes

You may be able to reduce leaks by making lifestyle changes.

Drink the right amount of liquid at the right time. Ask your doctor whether you should drink less liquid during the day. However, don’t limit liquids to the point of becoming dehydrated. Your doctor can tell you how much and when to drink based on your health, activities, and local climate.

To limit nighttime trips to the bathroom, you may want to stop drinking liquids a few hours before bedtime, but only if your doctor suggests it. Limiting foods and drinks with caffeine, such as chocolate, tea, coffee, and carbonated beverages, may help to reduce leaks. You should also limit alcoholic drinks, which can increase how much urine your body makes.

The amount of urine a person should make is different for everyone, based on how much liquid you drink, how much you sweat, how much liquid you use by breathing, and the medicines you take.

Be physically active. Although you may not feel like being physically active when you have UI, regular physical activity is important for weight management and good overall health. Even something like walking can improve your health. If you’re concerned about not having a bathroom nearby during physical activity, find a place with nearby restrooms, such as a shopping mall, community park, or local gym.

Keep a healthy weight. Your chances of developing UI and other diseases, like diabetes, are higher if you’re overweight or have obesity. Losing weight can help you have fewer leaks, and avoiding weight gain may prevent UI. Studies suggest that, as your body mass index (BMI) increases, you’re more likely to leak.2 If you’re overweight or have obesity, talk with your doctor about how to lose weight.

Avoid constipation. Constipation, can make urinary tract health worse and can lead to UI. Talk with your doctor about drinking more liquids and eating enough fiber to help avoid constipation. Doctors use medicines called antimuscarinics, such as oxybutynin and tolterodine, tricyclic antidepressants, and beta-3 agonists to treat UI, but they can cause constipation.

Stop smoking. If you smoke, get help to stop smoking. Quitting smoking at any age is good for your bladder health and overall health. Smoking raises your chances of developing stress incontinence, because smoking causes chronic, or long-lasting, coughing. You might improve your UI if you’re able to stop coughing.3

Smoking also causes most cases of bladder cancer. Some people say smoking makes their bladder more irritated.

A man and a woman stretch in a park.
You may be able to reduce leaks by being physically active and keeping a healthy weight.

Train your bladder

Bladder training is when you urinate on a schedule to help reduce leaking. Based on a bladder diary (PDF, 487.59 KB) , your doctor may suggest using the bathroom on a regular schedule, called timed voiding. Gradually lengthening the time between trips to the bathroom can help stretch your bladder so it can hold more urine. Record your daily bathroom habits so you and your doctor can review your diary.

Do pelvic floor muscle exercises

Strong pelvic floor muscles hold in urine better than weak muscles. You can make your pelvic floor muscles stronger by doing Kegel exercises. These exercises involve tightening and relaxing the muscles that control urine flow. A review of studies showed that women who received pelvic floor muscle training were much more likely to have improvement in their leaking than those women who didn’t get training.4 You should not do pelvic floor exercises while you’re urinating.

Men can also benefit from pelvic floor muscle exercises. Strengthening these muscles may help a man leak urine less often, especially dribbling after urination.

A health care professional, such a physical therapist trained in pelvic floor therapy, can help you get the most out of your Kegel exercises by helping you improve your core muscle strength. Your core includes your torso muscles, especially the lower back, pelvic floor muscles, and abdomen. These muscles all keep your pelvis lined up with your spine, which helps with good posture and balance. Your physical therapist can show you how to do some exercises during daily activities, such as riding in a car or sitting at a desk.

You don’t need special equipment for Kegel exercises. However, you can learn how to perform Kegel exercises properly by using biofeedback. Biofeedback uses special sensors to measure muscle contractions that control urination.

Control your urge to urinate

You may be able to suppress, or control, the strong urge to urinate, called urge or urgency suppression. With this type of bladder training, you can worry less about finding a bathroom in a hurry. Some people distract themselves to take their mind off needing to urinate. Other people find that long, relaxing breaths or holding still can help. Doing pelvic floor exercises to strengthen your pelvic floor also can help control the urge to urinate. Quick, strong squeezes of the pelvic floor muscles can help suppress urgency when it occurs, which may help you get to the toilet before you leak.

How can my doctor treat my bladder control problem?

If you can’t manage your UI using self-care and new habits, your doctor may prescribe medicine, a medical device, a bulking agent, or—as a last resort—surgery to help treat UI.

Medicines

For urgency incontinence your doctor may prescribe one of the following medicines in a pill, liquid, or patch to relax your bladder

  • antimuscarinics, such as oxybutynin and tolterodine
  • beta-3 agonists
  • beta-3 adrenergic receptor stimulators
  • tricyclic antidepressants

A doctor may use botulinum toxin A, or Botox, to treat urinary incontinence when other medicines or self-care treatments don’t work. Injecting Botox into the bladder relaxes it, which makes more room for urine and lowers the chances of developing UI.

For men. If you’re a man with UI, your doctor may prescribe another type of medicine, in addition to antimuscarinics, if you also have an enlarged prostate. These medicines include

Medical devices

Women and men with overflow incontinence may need to use a catheter to empty their bladder. A health care professional can teach you how to use a catheter. You may need to use a catheter once in a while, a few times a day, or all the time. Catheters that are used all the time drain urine from your bladder into a bag attached to your thigh with a strap. Watch for signs of a bladder infection if you use a catheter all the time.

For women. A pessary is a soft plastic ring used for stress incontinence that you or your doctor insert into your vagina. The pessary presses against the wall of your vagina and the nearby urethra. The pressure helps hold up the urethra, so you have less leaking.

Another newer product to treat stress incontinence is a tampon-like disposable device that you can insert into your vagina for up to 12 hours at a time. The product expands to push up against your urethra to help decrease leaks.

Bulking agents

During a short office visit, a doctor can inject a bulking gel or paste near your urinary sphincter to treat stress incontinence. The injected material “bulks” or helps thicken the area around the urethra and helps close your bladder opening so you have less leaking.

Electrical nerve stimulation

If you’ve tried other ways to stay dry, including medicines and lifestyle changes, and nothing has worked, your doctor may suggest electrical nerve stimulation for urgency incontinence and other symptoms. Electrical nerve stimulation involves changing your bladder’s reflexes using pulses of electricity.

A medical professional speaks to a woman in a doctor’s office.
If lifestyle changes don’t improve your urinary incontinence, speak with your doctor about other options.

Surgery

If you have overflow incontinence caused by a blockage or a narrowed urethra, a doctor can treat it with surgery to remove the blockage.

For women. A weak bladder neck or poorly supported urethra can cause stress incontinence and may be treated with some type of surgery. In sling surgery, a surgeon works through the vagina to insert a strip of material—usually mesh—in the tissue between the vagina and urethra. Mesh is a screenlike material that doctors can implant in your body to support the bladder or urethra or repair a hernia. A doctor performs the operation in a hospital or surgery center. You’ll receive general, spinal, or local anesthesia. Most women can leave the hospital the same day, though some may need to stay overnight. Full recovery takes 2 to 3 weeks.

Although sling surgeries with surgical mesh, sometimes called “mid-urethral slings,” can be successful and safe, serious complications can occur in some women. Your doctor can explain the risks and benefits of surgery for stress incontinence and what kind of results you can expect. He or she can help you decide whether surgery is right for you.

For men. Stress incontinence in men is sometimes treated with surgery. Surgery includes the artificial urinary sphincter (AUS) and the male sling procedures. A doctor performs the operations in a hospital. You’ll receive general or spinal anesthesia. Most men can leave the hospital the same day, though some may need to stay overnight. Your doctor can explain the risks and benefits of surgery for UI and what kind of results you can expect.

Minimally invasive surgeries are available for men with an enlarged prostate.

A doctor speaks to a patient.
Try using self-care and new habits to treat your bladder problem. If that doesn’t work, your doctor may prescribe medicine, a medical device, or a bulking agent.

How can I cope with bladder control problems?

Protective products

Even after treatment, you may still leak urine from time to time. Certain products can help you cope with leaking urine

  • Pads. You can wear disposable pads in your underwear to absorb leaking urine.
  • Absorbent, washable underwear. You can use underwear lined with extra fabric to absorb urine.
  • Adult incontinence briefs. You can wear incontinence briefs that act like diapers to keep your clothes dry.
  • Waterproof underwear. Waterproof underwear can protect your clothes from getting wet.
  • Large disposable pads. You can use large disposable pads to protect chairs and beds from urine.
  • External catheters. An external catheter can collect urine from a man’s body and drain it into a bag that is attached to the thigh with a strap.
  • Special skin cleaners and creams. Special skin cleaners and creams may keep your skin around the urethra from becoming irritated. Creams can help block urine from your skin.
  • Urine deodorizing tablets. Talk with your doctor about whether taking urine deodorizing tablets by mouth can make your urine smell less strong.

Emotional support

Bladder control problems are common, yet many people feel too embarrassed to talk about them. At the very least, talk with your doctor about your bladder problems. Your doctor can help you connect with a support group for people with similar problems.

Consider speaking with your family and friends about your UI. Your family and friends also may help find easier ways for you to use the bathroom regularly. In sharing your struggle, you may find that other people in your life have bladder problems as well.

References

June 2018
Share

This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings through its clearinghouses and education programs to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.