Medications may be helpful in the treatment of incontinence. For post-menopausal women, estrogen replacement therapy promotes a better seal of the urethra, frequently providing dramatic improvement. Estrogren supplements usually become effective within four to six weeks in cases of estrogen deficiency. Sympathomimetic drugs promote bladder control by tightening the bladder neck. These drugs are useful for mild or occasional stress incontinence.
Anticholinergics inhibit bladder muscle contractions.
When combined with timed voiding and fluid restriction, they can improve bladder stability and decrease the urge to urinate. Periurethral injections of materials such as collagen around the urethra are especially appropriate for elderly women with urethral wall damage who cannot tolerate surgery. Although several treatments are required, the procedure is performed on an outpatient basis using local anesthesia. Collagen's effectiveness can decrease over time, so reinjections are often required. Surgical treatments are designed to elevate and support the urethra and bladder neck.