Female Urinary Incontinence Research Part One: Bladder Retraining, Kegel Exercises, and Drug Treatment

This post covers behavioral treatments and drugs to treat female incontinence. For information on electrical stimulation, vaginal devices and surgery to treat female incontinence please see “Part One” of this article series.

Female Urinary Incontinence (“Incontinence” or “Female Incontinence”) is a condition shared by millions of women. The condition manifests itself differently in different women; some women may lose a few drops of urine while doing something as mundane as running or coughing while others may feel a sudden urge to urinate just before losing a large amount of urine.

Understanding Female Incontinence
Incontinence can be slightly bothersome or totally debilitating. For some women, the risk of public embarrassment keeps them from enjoying many activities with their family and friends. This article briefly explores how to deal with this condition.

Female Incontinence is a medical problem. A medical professional is best equipped to prescribe the solution that best fits an individual’s lifestyle preferences. While no single treatment works for everyone, most women can be treated without surgery.

Treating Female Incontinence
Many women try simpler treatment options first, such as modifying their habits and doing exercises to strengthen the muscles that hold urine in the bladder. If these behavioral treatments do not work, the next steps are to investigate medication or vaginal devices. Sometimes mild electrical stimulation to the pelvic nerves may help. For some women, however, surgery is the best solution.

Female Incontinence: Bladder Retraining and Kegel Exercises
Some medical professions work with their patients to have them keep bladder diary—a record of your fluid intake, trips to the bathroom, episodes of urine leakage, and an estimate of the amount of leakage. A review of this record helps doctors and nurses identify treatable patterns and they may suggest day-scheduling changes such as using the bathroom at regular timed intervals (“timed voiding”). Behavioral treatment also includes Kegel exercises to strengthen the muscles that help hold in urine.

Female Incontinence: Drugs and Treatment
Overactive bladder occurs when abnormal nerves send signals to the bladder at the wrong time, causing its muscles to squeeze without warning. Normally, a woman might void up to 12 times a day, but women with overactive bladder may find that they must urinate more frequently. Specifically, the symptoms of overactive bladder include
• urinary frequency—urination 13 or more times a day or 2 or more times at night
• urinary urgency—the sudden, strong need to urinate immediately
• urge incontinence—leakage or gushing of urine that follows a sudden, strong urge

In these situations, a doctor can prescribe medications medicine to block the nerve signals that cause frequent urination and urgency. These “bladder relaxants” relax muscles and prevent bladder spasms; two medications available today in that category are Ditropan and Detrol. Both medications come in normal and extended relief, long lasting strengths (Ditropan XL or Detrol LA).

Additionally, Tofranil, an antidepressant that relaxes bladder muscles and tightens urethral muscles, may be used instead of (or in combination with) Ditropan XL or Detrol LA.

The most common side effects (read the medication warnings for a full listing of the side effects) include dry mouth. If medication is your treatment route for female incontinence, several precautions are recommended:
• Wear sunglasses if your eyes become more sensitive to light.
• Take care not to become overheated.
• Chew gum or suck on sugarless hard candy to avoid dry mouth.

Different medicines can affect the nerves and muscles of the urinary tract in different ways. Pills to treat swelling (edema) or high blood pressure may increase urine output and contribute to bladder control problems. An educated conversation with a medical professional could result in a switch to an alternate medication that could solve the problem without adding another prescription.