Management Options | Urinary Incontinence Decision Aid

Option 1: Monitor Your Water Intake

Drink 6 to 8 glasses of non-caffeinated drinks in a day. This will make sure that urine is not strong. Concentrated urine can increase bladder irritability.

PROS: May reduce how often you feel like going to the bathroom.
CONS: Need to be motivated and have to remember to drink.

Option 2: Reduce Your Caffeine Intake

Reduce the amount of tea, coffee and pop you drink to less than 2 cups or switch to decaffeinated drinks because the caffeine may make you want to urinate more and may also irritate your bladder.

PROS: May decrease how often you feel like going to the bathroom.
CONS: May get headaches if you reduce caffeine too quickly. Need to be motivated.

Option 3: Maintain a Healthy Weight

Keep your weight to what is healthy for you. If you are overweight, the body weight can increase the pressure on the pelvic floor.

PROS: Your ideal weight has other health benefits for you.
CONS: Need to be motivated and have good eating habits and regular exercise.

Option 4: Prevent Constipation

Make sure you keep your bowels regular. Constipation can increase the pressure in your tummy and make you urinate more often.

PROS: This can reduce urinary incontinence.
CONS: You need to be motivated and have good eating habits and regular exercise.

Option 1: Regular Pattern

Remind yourself to urinate at regular times. Adopt a pattern that works for you.

PROS: Will reduce the need to rush to the toilet.
CONS: Need to be motivated. Need to follow consistent schedule to go urinate

Option 1: Use Effective Continence Products

Use proper continence products to absorb urine for comfort and freshness.

PROS: Keep you comfortable and fresh without odors.
CONS: There is an ongoing cost for the products.

Option 1: Vaginal Cones

Vaginal cones can be used to strengthen the pelvic muscles. You insert a cone in the vagina and you hold it there for 10 minutes by squeezing your muscles. You do this two times a day. Each cone is the same size but different weights. This allows you to increase the weight of the cone you are using as your pelvic muscles get stronger.

PROS: The cones are another way to strengthen the pelvic muscles.
CONS: You need to pay for the cones. Using cones may not be as effective as doing pelvic muscle exercises only.

Option 2: Correct Pelvic Muscle Exercises

Learn proper pelvic muscle exercise from an experienced health professional.

PROS: Strong pelvic muscles better support the bladder.
CONS: The correct way to do these exercises is often not well described. This can reduce how effective the exercise is.

Option 3: Biofeedback

Biofeedback is used to show you how well you are contracting your pelvic muscles. A probe is inserted in your vagina to measure the muscle contractions.

PROS: Ensure pelvic exercises are done correctly.
CONS: There is a cost for biofeedback procedure. May not work better than doing pelvic muscle exercises only.

Option 4: Vaginal Pessary

Vaginal Pessary is a device inserted in the vagina to support the bladder and the urethra.

PROS: The pessary begins to help right away.
CONS: There is a cost for the pessary. Requires monitoring by health professional.

Option 1: Anticholinergic Medication

Anticholinergic medication helps to reduce the irritability in your bladder and relax the bladder muscle.

PROS: Allows bladder to hold more urine.
CONS: Often causes dry mouth and eyes and constipation.

Option 2: Local Estrogen

Local estrogen (vaginal cream, pellet or ring) may help to improve the quality of tissues in the vagina, urethra and bladder.

PROS: Easy to use, works in the vagina, urethra and bladder but is not absorbed into the blood.
CONS: Needs to be used with caution in women with a history of breast cancer.

Option 1: Bladder Suspension Surgery

Bladder Suspension is a surgery used to treat bladder neck weakness by raising and securing the bladder neck to its proper position in the body.

PROS: Has good long term outcomes.
CONS: All surgery has risks including not fixing the problem of urinary incontinence, damage to nearby organs, infection and life threatening bleeding. Requires a longer stay in hospital and slower return to normal activities.

Option 2: Low Tension Sub Urethral Tapes

Low Tension Sub Urethral Tapes (TVT or TOT) provides extra support to the bladder neck.

PROS: Generally done as an outpatient procedure. This results in quicker return to normal activities.
CONS: All surgery has risks including not fixing the problem of urinary incontinence, damage to nearby organs, infection and life threatening bleeding.

Option 3: Laparoscopic Colposuspension Surgery

Laparoscopic Colposuspension is a surgery that lifts the neck of the bladder and attaches it to the pelvic ligaments with some strong stitches.

PROS: Avoids a major incision which results in quicker return to normal activities
CONS: Avoids a major incision which results in quicker return to normal activities
All surgery has risks including not fixing the problem of urinary incontinence, damage to nearby organs, infection and life threatening bleeding.

*The success may not be as good as the bladder suspension or the sub urethral tape.

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