First Options for Incontinence Treatment

• Medications – Options may include antibiotics to treat infection, anticholinergic medicines to relax bladder contractions, and antidepressants to “paralyze” the smooth muscle of the bladder.
• Dietary Changes – These can include changing the amount and timing of liquid consumption and avoiding caffeine or highly acidic and spicy foods.
• Physical Therapy
  • Bladder Retraining – This usually involves setting a schedule of times to urinate and trying to gradually increase periods between bathroom visits.
  • Pelvic Muscle (Kegel) Exercises – The purpose of these exercises is to strengthen the muscles of the pelvic floor to improve bladder control. It can be combined with biofeedback, or a sensor placed in the vagina or anus, to ensure that the right muscle groups are being worked.
• Electrical Stimulation – This treatment uses painless, low-voltage electric current to stimulate the pelvic muscles. 

Although these options do not provide treatment for urinary incontinence, they may help manage symptoms.

• Pessaries and Inserts (women only) – Pessaries are a fitted device inserted in the vagina to support the bladder and/or compress the urethra (the tube that carries urine out of the bladder). Urethral inserts are a narrow silicone tube inserted into the urethra with a disposable applicator. Inserts are not meant to be worn 24 hours a day, and therefore work best for women with predictable incontinence during selected activities.
• Penile Clamps (men only) – Often designed to wrap around the penis, penile clamps apply pressure to keep the urethra closed, to prevent urinary leakage.
• Absorbent Pads and Garments – Fitted underwear, pads, liners, shields and guards are available in both disposable and reusable designs. 

Because of their relative safety and effectiveness, conservative treatments and management options are often the first approaches recommended by your physician. Only your health care provider can determine if they are right for you.

If results are not satisfactory, then more invasive procedures may be tried, such as:

• Surgery
• InterStim^® Therapy
• BOTOX^® treatment