Medications

Urinary incontinence may be treated with medicines. But in many cases, treatment with behavioral methods (bladder training, timed urination) and Kegel exercises are tried before medicines. These treatments, when combined with medicine, may help some women more than either treatment alone.

Medication Choices

Stress incontinence:

• Antidepressant medicines, such as duloxetine (Cymbalta) or imipramine (Tofranil)

Urge incontinence:

• Anticholinergic medicines, such as oxybutynin (for example, Ditropan or Oxytrol) and tolterodine (Detrol)
• Imipramine (Tofranil), often used in combination with an anticholinergic medicine

Surgery

There are several different kinds of surgeries to correct stress incontinence, which occurs when weakened pelvic floor muscles allow the bladder neck and urethra to drop. These surgeries seek to lift the urethra, the bladder, or both into the normal position. This makes sneezing, coughing, and laughing less likely to make urine leak from the bladder.

Surgery works to cure stress incontinence better than any other treatment. If other treatments (like pelvic floor muscle exercises) haven't worked to control your incontinence, surgery may be your best option. What kind of surgery you have depends on your preference, your health, and your doctor's experience.

Surgery is done much less often for urge incontinence, and the results are not as good.

Stress Incontinence: Should I Have Surgery?

Surgery Choices

• Tension-free vaginal tape (TVT) surgery
• Retropubic suspension
• Urethral sling
• Sacral nerve stimulation (SNS)
• Urethral bulking