Common Treatments for Stress Urinary Incontinence

Pubovaginal Sling Surgery

Currently, this is one of the most common procedures, surgical or otherwise, performed to correct SUI and its associated symptoms. It is a surgical option, in which a sling made of either tissue or artificial material is placed underneath the urinary sphincter, to prevent it from moving downwards as a result of abdominal pressure, preventing leakage.

The sling also supports a weakened sphincter, increasing the threshold before urine leakage occurs. This treatment option had a good overall success rate and a long term cure rate of 70-95%. However, recent analysis has revealed that the actual cure rate might be lower than what has been reported in past studies.

Cons of Pubovaginal Sling Surgery

There are associated risks with any surgery, and the pubo-vaginal sling procedure is major surgery. If the sling is tied too tightly, it can actually lead to a urethral obstruction, which can cause problems when urinating.

Other complications include hemorrhage, infection, the risks of anesthesia, the formation of blood clots, unintended injury to pelvic nerves, muscles and even damage to the bladder. The success of the surgery is dependent on the experience of the doctor and the material used.

Finally, surgical procedures are not inexpensive, many result in surgical scars, and have a longer recovery time.

Artificial Mesh

Artificial mesh (also known as surgical mesh) is one of the materials that can be used to create a sling in the pubo-vaginal sling surgery. One of the mesh materials used, a polypropylene – meshed tape is known as tension-free vaginal tape (TVT-tape).

Cons of Artificial Mesh

As established above, the pubo-vaginal sling surgery in itself is major surgery. In addition to that, there are certain added risks of using an artificial mesh which can take place in certain cases.

Along with urethral obstruction caused by a tight sling, artificial mesh has also been associated with vaginal prolapse and a rarer side effect of mesh exposure into the vagina after surgery. These side effects are rare, and currently, mesh sling surgeries are considered a standard solution for SUI.

Medication as Treatment For Stress Urinary Incontinence

Currently, there are no medications approved specifically for the treatment of SUI and its symptoms in the United States. However, in Europe, the duloxetine, an anti-depressant has been prescribed for treating stress incontinence, with very limited positive results.

Cons of Medication

Any benefit seen from the use of medication in reducing SUI symptoms is dependent on consistent usage of the medicine. As soon as the medicine is stopped, the symptoms return quickly. The medication is also associated with causing nausea as a common side effect, which results in low compliance.

Adult Diapers and Pads

One obvious solution to prevent soiling of underwear and pants and reducing the number of trips made to the restrooms during a work day is the use of adult diapers.

By wearing diapers or pads, one can continue doing their work or running their errands until they are able to reach a bathroom and change diapers. Diapers may reduce the fear of leakage of urine in public or before a toilet can be reached.

Cons of Adult Diapers and Pads

The decision to wear adult diapers is not easy. The added reminder of the loss of bladder control whenever they change diapers results in further feelings of self-shame and low self-confidence as an adult.

In addition to the mental ramifications, wearing adult diapers adds a lot of restriction to one’s life. There are certain clothing items that can no longer be worn because they wouldn’t be able to hide the diaper underneath, causing embarrassment.

It also restricts movement due to its added bulk and diapers are quite expensive to purchase and use on a daily basis. The use of adult diapers also does nothing to solve the actual problem of SUI, but only seeks to offer a solution for urine leakage.

Kegel Exercises or Pelvic Exercises to Strengthen the Muscles

As a part of behavioral therapies which includes reduced fluid consumption on a timetable and scheduling toilet breaks, your physician might also recommend a series of exercises known as Kegel exercises. The aim of these exercises is to increase the strength of the pelvic floor muscles, thereby increasing stamina for withstanding abdominal pressure leading to leakage of urine.

Cons of Kegel Exercises

The efficacy of Kegel exercises in reducing SUI symptoms varies from case to case. It may not result in any viable difference at all in certain cases. As it is essentially a workout routine, it needs to be carried out regularly to maintain any relief that is experienced and does not result in a long-lasting quick fix. In some cases, women might not be physically strong enough to perform these exercises, due to advanced age or pre-existing medical condition, thus rendering this solution option incompatible for them.

Home Remedies

There are certain lifestyle changes which can help ease the SUI symptoms, though the degree of relief and effectiveness varies from individual to individual and in some cases, there might not be any relief at all. All the home remedies attempt to reduce SUI symptoms by indirect methods. Some of the healthier habits that supposedly counter symptoms of SUI include:

Reducing weight: Obesity is defined as having a body mass index (BMI) of 25 or higher. By shedding extra weight and returning to a normal BMI, it is thought that the overall physical pressure experienced by the bladder and the muscles of the pelvic floor is reduced. It can result in mild to moderate relief of symptoms in some cases.

Eating more fiber: In certain cases, it is possible that chronic constipation is the reason behind SUI. Thus, by adding more fiber to diet such as whole grains, fruits, vegetables and oatmeal, the aim is to make bowel movements more regular and softer, which would, in turn, cause a reduction in strain faced by pelvic floor muscles.

Cessation of smoking: In addition to the damage caused to the respiratory system

Avoiding food and drink which are bladder irritants: Certain food substances such as caffeinated beverages coffee, tea, etc. result in increased frequency of urination. Abstaining from these substances or reducing their intake can possibly reduce the chances of urine leakage.

Cons of Home Remedies

While these habits can help decrease the risk of developing SUI, their impact on reducing the symptoms of SUI once developed is unclear and not the same for each individual. They also don’t result in immediate results and the added strain of lifestyle change in addition to suffering from SUI can make this solution tiresome.

Doing Nothing

Certain individuals may simply decide to accept SUI and leakage of urine throughout their days as their new reality. They may decide to seek no treatment or attempt to correct the incontinence and assent to a lower quality of life as a result.

While all the above-mentioned treatments are associated with good outcomes in many cases, the negative ramifications of the procedures themselves outweigh any good that they achieve. They are either risky, invasive in nature, require surgery, are expensive or only alleviate symptoms and provide relief for short periods of time only. This only seeks to further increase the anguish experienced by women already dealing with SUI.

Compared to these methods, the progression of science and medicine has resulted in the development of treatment techniques for SUI which are relatively quick, easy, painless and comparatively inexpensive. These new solutions for SUI are fast acting and potentially long-lasting.