### Instruction:  Disease name:

    Urinary Incontinence

: Treatment

Kegel Exercises
 Many women can improve or eliminate urinary incontinence by doing pelvic muscle exercises. These are called Kegel exercises. They strengthen the muscles that surround the openings of the urethra, vagina and rectum.   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. 
Bladder Retraining
 Urge incontinence can be improved by retraining. The goal is to help your bladder become less sensitive to the things that trigger its tendency to squeeze down and create a tremendous urge to urinate—or urination, itself.   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. 
Medications
 Many medications are available to reduce symptoms of urge incontinence. Initial choice often depends upon cost and potential risk of side effects. Women who have a UTI are given antibiotics. Curing the infection ends the incontinence caused by infection.  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
 Your doctor may recommend using cone-shaped weights. You place one of these cones into your vagina before you begin pelvic muscle exercises. These maximize the muscle-conditioning effect of Kegel exercises.  
Pessaries
 Urine leakage may be caused when the uterus sags into the vagina (a condition called uterine prolapse), bending the urethra. In these cases, a pessary may help. A pessary is a firm rubber ring that supports the bottom of your uterus, and keeps it from prolapsing. It can be inserted in the vagina by a physician and worn continuously. 
Surgery
 A common cause of stress incontinence in women is lack of support at the bladder neck. Surgery may be considered when other treatments have been ineffective.   Other Strategies
If your urine leaks when you cough, seek treatment for your cough. If your cough results from smoking, talk to your doctor about ways to quit. 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.