What treatments are available for women who have stress incontinence?

What treatments are available for women who have stress incontinence?

Jennifer Anger, M.D, M.P.H. (Assistant Professor) gives expert video advice on: What kind of doctor can help me with bladder control?; What treatments are available for women who have stress incontinence?; What treatments are available for men who have stress incontinence? and more...

For stress incontinence in women, we start with Kegel exercises, and maybe some fluid restriction. If that doesn't work, then we offer surgery. Minor procedures that can be done in the office include bulking agents, which bulk the urethra and help stress incontinence temporarily. Such agents include collagen, and there are newer products such as Coaptite which can help bulk up the urethra, but these are temporary. I usually reserve these procedures for people who really don't want surgery. Surgery is very effective for stress incontinence. My preferred surgical treatment is the sling procedure, which involves a small piece of synthetic mesh that is placed through an incision in the vagina, and comes out through two tiny incisions that are in the abdominal area, the very low abdominal area. The two little incisions come out through the area just above the pubic bone. The sling is quite effective for stress incontinence. The procedure itself takes about half an hour. The patients usually go home the same day. There are risks to any surgical procedure, but they tend to be very low. There is also the Birch procedure, which is a commonly performed procedure and was the gold standard until the slings have sort of taken over. The Birch procedure is performed, often, at the time of a hysterectomy. It is an abdominal procedure, and that also has very good efficacy for treating stress incontinence.