To do Kegel exercises, squeeze your muscles to tighten your rectum and vagina. Hold Kegel squeezes for 6 to 8 seconds. Group 8 or 12 squeezes into each session. You can repeat these exercises several times each week.
Kegel exercises are particularly helpful for stress incontinence. They can also help control other types of incontinence. It can take several months or longer to see benefits.
The squeezing of your bladder is a conditioned response. You need to give your bladder a period of time when it is not stimulated by the signal of a full bladder. This helps your bladder to be less "jumpy."
To accomplish this, empty your bladder on a rigid schedule before it becomes full. You may need to urinate every half hour or hour. Gradually lengthen the interval between your bathroom stops. Your bladder may not respond as urgently after several weeks of retraining.
You also can improve urge incontinence by calming your bladder signals. Try not to race to the bathroom when you feel an urge to urinate. Instead, try sitting and breathing deeply for a short time. Or do Kegel exercises to distract your bladder.
Some specialists provide bladder sphincter biofeedback. This shows levels of bladder, rectum and abdominal pressure during Kegel squeezes or during relaxation techniques.
Women who have a UTI are given antibiotics.
Some post-menopausal women have vaginitis caused by too little estrogen. Estrogen creams or tablets in the vagina can be helpful. Estrogen does not help urinary incontinence in women who do not have vaginitis.
Devices to Strengthen the Pelvic Muscles
The goal of surgery is to wrap the urethra with a "sling" of fibrous tissue or loops of suture material. (The urethra is the drainage tube for the bladder.) The urethra is then tethered to the pelvis so it won't sag or shift off center.
Surgery can be done through an incision above the pubic bone or in the vagina. In some cases, a needle-shaped instrument is used. After pain-killing medicine is injected, the instrument is inserted through the skin above the pubic bone or the front wall of the vagina.
Some specialized medical centers use robotic surgery. Instruments attached to metal rods are inserted into the pelvis through small incisions. The instruments on the rods are maneuvered by a surgeon. The surgeon uses a remote control while watching a magnified video screen.
Occasionally, the bladder neck can be thickened by injecting a non-absorbable material. This can help some people to hold urine more easily.
Rarely, an electrical stimulator may be surgically implanted. This device periodically stimulates the nerve that controls bladder function and pelvic muscles. This may reduce symptoms in certain people who have urge incontinence or bladder overflow.
Pads or adult diapers can offer security. But they can also irritate the skin. They should not be the first or only treatment used for incontinence.
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From Health A-Z, Harvard Health Publications. Copyright 2007 by the President and Fellows of Harvard College. All rights reserved. Written permission is required to reproduce, in any manner, in whole or in part, the material contained herein. To make a reprint request, contact Harvard Health Publications. Used with permission of StayWell.
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