Therapeutic management of stress urinary incontinence
Do you have stress urinary incontinence (SUI)? If so, you are not alone. Several methods can help alleviate SUI, ranging from lifestyle modifications to surgery and various continence aids. Here you'll learn a little about some alternatives.
A general rule when treating SUI is to use the least invasive method available or the one with the lowest “risk”. Conservative management restricts treatment to non-surgical and non-pharmacological approaches. You may try one or more alternatives over several months before further treatment methods are considered. Examples of conservative management are:
Lifestyle changes: Lifestyle changes may involve fluid management, weight loss, regulation of caffeine intake or quitting smoking. Some may seem a bit over the top; however, say with smoking, it can cause a recurring cough, which again may cause SUI.
Pelvic Floor Exercises: SUI occurs as a result of weakened muscles and/or ligaments in the pelvic floor. Doing pelvic floor exercises (also known as PFMT or Kegels), improves the body’s ability to stop leaks from happening.
Intravaginal devices: Also, in the realm of conservative management, you’ll find intravaginal devices. They provide mechanical support through the vaginal wall. Often called bladder supports or pessaries, how they look and how you use them vary. Some can only be used once; others are reusable. Some need to be tried out, or fitted, by a medical professional, some you can try out yourself. Sometimes, these products are only available on prescription.
Pharmaceutical treatment and mid-urethral sling surgery
Pharmaceuticals or hormones are sometimes offered as treatment. Hormonal therapy with estrogen may strengthen the mucosa of the urethra, as well as can help strengthen the muscles and nerves in the vaginal wall. But, even if it’s administered locally, there is always the risk of side effects.
That also applies when using pharmaceuticals to treat SUI. Pharmaceutical treatment for SUI is not common due to the side effects. And, one may often only be able to use medication on rare occasions, again because of the side effects.
Surgery is the only method where a once-only action can cure SUI. The most common is called the TVT method (tension-free vaginal tape). A sling is placed under the urethra, which then should provide the same support you would otherwise get from the pelvic floor muscles and ligaments. For varying reasons, surgery is not an option for everyone. And, as with any surgery, there are always risks for complications.