Non-surgical treatments are always tried first and are usually effective. For urge incontinence, the mainstay of treatment is medications and bladder retraining in an attempt to relax the bladder and reduce the contractions, thereby reducing the sense of urgency. Estrogen replacement therapy can be helpful as it thickens the tissues that support the urethra and bladder. Surgery to tighten the loose, relaxed muscles and ligaments causing the problem may be an option for certain cases of incontinence. Rather, it is a symptom of a structural, functional or neurological disorder and can be treated or improved, notes Michelle Eslami, M.D., assistant clinical professor of geriatrics.
Women are more susceptible to incontinence than men.
In women under 75 years of age, the most common type is stress incontinence in which women lose urine with some type of stress maneuver - sneezing, coughing, laughing, or with exercise. In women over 75 years of age, urge incontinence is more prevalent, with the woman feeling an urge to urinate even if the bladder is not full, and then not being able to get to a bathroom soon enough. Sometimes a woman can have a combination of stress and urge incontinence. In addition, medicines that relax the bladder can be used for urge incontinence, while drugs that tighten the urinary sphincter are useful for some types of stress incontinence. For women who have stress incontinence due to a prolapse of the bladder or other pelvic organs, a surgery to resuspend the bladder may be very effective.