1. Determine the Cause
To determine the best method of treatment for female urinary incontinence, your doctor will need to give you a complete medical exam, including an examination of your pelvic region. You may also need to keep a journal for a few days detailing how much and how often you drink, how frequently you urinate and whether you experience any accidents or leakage. Your doctor may also order another type of test such as a bladder stress test, in which fluid will be inserted into your bladder and then any leakage measured after you've been asked to cough. A pad test will show how often you pass urine throughout the day. If your condition is serious, you may even need to undergo urodynamic testing including cystometry and ultrasound.
2. Use Medication to Control Symptoms
Your doctor will first suggest you make dietary changes, attempt to retrain your bladder to go on a set schedule every few hours and strengthen your pelvic muscles using Kegel exercises. If problems with female incontinence persist, then and only then will the doctor suggest the use of medication. Stress incontinence is treated using the antidepressant medicines duloxetine or imipramine, although these are only successful in some women. Imipramine may also be used to treat urge incontinence. Other medications used for this type of incontinence include anticholinergic drugs, such as Ditropan, Detrol and Oxytrol.
3. Surgical Options for Correction
Urge incontinence is usually not treated with surgery, but there are several surgical options available to correct stress incontinence. Tension-free vaginal tape (TVT) surgery, in which a meshlike tape is positioned under the urethra to help support it and return it to its normal position, can be done under local anesthesia as an outpatient procedure and shouldn't take much more than half an hour to perform. Retropubic suspension surgeries lift up the sagging urethra and bladder neck by attaching their supporting tissues to tough ligaments or to the pubic bone. This type of surgery will require a hospital stay, as will urethral sling surgery, wherein a piece of tendon, muscle or ligament tissue or synthetic material is fashioned into a sling to lift the urethra back into its normal position. Surgical treatment may be less effective for you if you are obese, elderly, have a chronic cough, have low estrogen levels as a result of having undergone menopause or a hysterectomy, have poor nutrition or participate in strenuous physical activity.
