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Beyond Kegels: Exploring Advanced Treatments for Urinary Incontinence
Published: Oct 04, 2024
While Kegels and lifestyle modifications help many women with urinary incontinence, some may need additional treatments. This article explores the next steps in managing persistent incontinence symptoms.
Pessaries: A Non-Surgical Option
A pessary is a small device inserted into the vagina to support the bladder and reduce leakage. It's particularly useful for stress incontinence. Pessaries come in various shapes and sizes and are fitted by a healthcare provider. They can be a good option for women who want to avoid surgery or can't have surgery for medical reasons.
Medications for Overactive Bladder
For urgency incontinence, medications called anticholinergics can help relax the bladder muscle. These include oxybutynin, tolterodine, and solifenacin. Another type of medication, mirabegron, works differently but has a similar effect. These drugs can have side effects like dry mouth and constipation, so they're not suitable for everyone.
Surgical Solutions
If other treatments don't work, surgery might be an option. The most common procedure for stress incontinence is the midurethral sling, where a small mesh tape is placed under the urethra for support. For severe urgency incontinence, treatments like Botox injections into the bladder or sacral neuromodulation (which uses electrical pulses to control bladder function) may be considered.
Frequently Asked Questions
Coverage varies, but many insurers cover medically necessary incontinence treatments.
With proper care, a pessary can last several years.
Not necessarily; it depends on the individual case and patient preference.
Some treatments are suitable for men, but options may differ.
Finding Your Solution
With a range of treatment options available, most women can find an effective way to manage their urinary incontinence and improve their quality of life.
References
- Richter HE, et al. Continence pessary compared with behavioral therapy or combined therapy for stress incontinence. Obstet Gynecol 2010; 115:609.
- Imamura M, et al. Surgical interventions for women with stress urinary incontinence. BMJ 2019; 365:l1842.
- Gormley EA, et al. Diagnosis and treatment of overactive bladder (non-neurogenic) in adults: AUA/SUFU guideline amendment. J Urol 2015; 193:1572.
This article has been reviewed for accuracy by one of the licensed medical doctors working for Doctronic. Always discuss health information with your healthcare provider.
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