Key Takeaways

• Female urinary incontinence is common and treatable, with solutions tailored to its type, cause, and patient history.
• Behavioral therapies such as bladder training and toileting assistance help improve bladder control and reduce leakage.
• Pelvic floor rehabilitation – including Kegels, biofeedback, and vaginal weight training – strengthens muscles that support continence.
• Medications and surgical options are available when conservative treatments and lifestyle changes are not effective.
• Urinary incontinence is not an inevitable part of aging, and combining treatments often provides the best results.

Dr. Alex Culbreth, a respected physician based in Valdosta, GA, specializes in obstetrics and gynecology at Southern OBGYN Associates. As a partner at the practice, he performs advanced procedures including robotic-assisted surgery and conservative treatments for conditions such as endometriosis and female urinary incontinence. With years of experience in women’s health, Dr. Culbreth brings a compassionate approach to care and a focus on educating patients about their options. His leadership extends beyond the clinic, serving on boards for community and medical organizations throughout GA. The following article outlines key treatment methods for female urinary incontinence, an issue Dr. Culbreth frequently addresses in his practice.

Treatment of Female Urinary Incontinence

Urinary incontinence is a common condition affecting more than 25 million Americans. Women are twice as likely as men to have the condition. Loss of bladder control and leaking of urine characterize it. Below are some common treatment options for female urinary incontinence.

Treatment of female urinary incontinence depends on the type of incontinence, medical history, the cause of the condition, and age. A patient’s tolerance to specific therapies, procedures, and medications may also determine the choice of treatment.

Because incontinence is often a symptom of an underlying condition, treatment may focus on both the cause and symptoms. Sometimes, urinary incontinence resolves with the treatment of the cause, such as constipation. Some causes, however, cannot be treated, such as pregnancy, age, and Parkinson’s disease.

Where the underlying condition is irreversible, doctors may opt for behavioural therapies, such as bladder training and toileting assistance. They can help treat common symptoms of loss of bladder control: increased urge to urinate frequently and a feeling of incomplete bladder emptying.

Bladder training teaches patients to resist the urge to go every time they get the urge by building endurance. Toileting assistance concerns creating a habit of urinating at specific intervals, which not only prevents leakage but also trains the bladder to hold between bathroom visits.

Urologists may also opt for rehabilitation exercises, such as Kegel exercises, biofeedback, vaginal weight training, and pelvic floor stimulation. Kegel exercises help resolve leaking and uncontrolled urge to urinate by strengthening the pelvic muscles. Doctors use biofeedback to help individuals become more aware of their pelvic muscle movement during Kegel exercises.

In vaginal weight training, individuals hold small weights within the vagina. It helps treat stress incontinence, which may happen during exercise, laughing, sneezing, or heavy lifting. In pelvic floor electrification stimulation, a physician uses pulses to stimulate contractions in the pelvic muscles. It strengthens the pelvic muscle floors.

Some women develop urinary incontinence due to an unhealthy lifestyle. Common culprits include excess weight, smoking, and excessive consumption of alcohol and caffeine. Caffeine irritates the bladder, while alcohol increases the urge to urinate. Acidic and spicy foods may also irritate the bladder. Diet modification and exercising regularly may help reduce urinary incontinence.

If stress incontinence persists even after behavioral therapies and lifestyle changes, the next option is medication. A doctor may prescribe duloxetine to help increase muscle tone and alleviate stress incontinence. Oxybutynin and tolterodine reduce urge incontinence. They may also help with an overactive bladder, which causes frequent urges to urinate. Where muscle toners fail, mirabegron or vibegron helps relax the bladder, reducing urge incontinence by causing the bladder to fill up.

Another option is surgery. In colposuspension, a surgeon makes a small incision in the patient’s abdomen, lifts the bladder by the neck, and stitches it in this elevated position. It helps treat stress incontinence.

During sling surgery, the doctor makes a small cutting in the lower belly and vagina and inserts a sling around the neck of the bladder, thus supporting it and preventing leaking. The sling is a tissue extracted from the patient, a donor, or an animal. While it may aggravate incontinence or lead to new issues, it’s also the most documented procedure.

When all else fails, the only option may be to prevent leakage. The doctor may insert a pessary in the vagina. Another alternative is to wear absorbent underclothing, pads, or diapers.

While urinary incontinence is more prevalent among older individuals, it isn’t a normal part of growing old. It’s usually a symptom, and anyone can experience it. It’s also manageable. Limiting fluid intake, however, doesn’t manage it. It constricts the bladder and causes dehydration and ultimately constipation. Straining to poop weakens the pelvic muscles. Combining treatments may maximize the outcome.

FAQs

What causes female urinary incontinence?

Causes range from reversible factors like constipation to chronic conditions such as pregnancy, aging, neurological disorders, or weakened pelvic muscles.

Can lifestyle changes improve urinary incontinence?

Yes. Weight loss, quitting smoking, limiting caffeine and alcohol, and making diet adjustments can reduce bladder irritation and improve symptoms.

What conservative treatments are commonly used first?

Behavioral therapies such as bladder training, toileting schedules, and pelvic floor exercises are typically the first line of treatment.

When are medications recommended?

Doctors may prescribe medications like duloxetine, oxybutynin, tolterodine, mirabegron, or vibegron when lifestyle changes and exercises do not fully relieve symptoms.

What surgical options are available?

Procedures such as colposuspension and sling surgery can provide support to the bladder and urethra when conservative treatments are ineffective.

About Alex Culbreth

Based in Valdosta, GA, Dr. Alex Culbreth is a partner at Southern OBGYN Associates, where he offers advanced surgical and nonsurgical care in gynecology. His expertise includes robotic-assisted procedures, pelvic mass removal, and treatment of urinary and cervical incontinence. He has also served as chief of staff at South Georgia Medical Center and remains active on its Robotic Surgery Steering Committee.