Nonsurgical treatment options include physical therapy and exercise, biofeedback, behavioral therapy, medication and bladder support devices called pessaries. Exercises, such as the Kegel exercise, can strengthen pelvic and urethral muscles that help control urinary flow. Biofeedback teaches ways to control the bladder and sphincter muscles by recording muscle action onto a screen so that you can see and, therefore, learn to strengthen these muscles. Behavioral therapy teaches ways to retrain the bladder, such as being on a routine urinating schedule. The type of medication used depends on the problem.
Some drugs act as bladder relaxants, while others work to strengthen muscle contraction.
Pessaries are temporary devices that are placed in the vagina to reduce leakage and must be changed often. Pessaries can relieve symptoms, but they do not cure incontinence. Collagen implant therapy is a newer, highly effective technique performed on an outpatient basis. It helps many women with stress incontinence avoid major surgery. Collagen is injected into the urethral tissues and acts as a bulking agent by bringing the walls of the urethra closer together or by sealing off the base of the bladder.