Treatment and therapy of urinary incontinence
Individually designed treatment can start after diagnosing the type and causes of urinary incontinence. The appropriate therapy can alleviate or even cure the problems of incontinence in most cases. It is important that patients overcome any feeling of embarrassment and consult a doctor.
Therapies depend on the underlying cause of incontinence and include:
Pelvic floor training
Pelvic floor training strengthens the muscle groups of the pelvic floor and the sphincters supported by the pelvic floor. Regular training modules aim at regaining voluntary control of the bladder und thus continence. A competent physiotherapist or other expert in the area shall explain the exercises to make sure that the correct muscle groups are trained. Training includes awareness, power, snapping power, endurance, coordination and relaxation. Pelvic floor training is mainly suitable for the therapy of stress incontinence.
Many patients find it difficult to voluntarily activate their pelvic floor / sphincter muscles and biofeedback provides information to make sure that the correct muscles are used and/or contracted during pelvic floor training. Intracorporeal electrodes may be used depending on the affected region. Visual and acoustic feedback of pelvic floor contractions supports conscious awareness. Biofeedback (e.g. combined with electrotherapy) trains voluntary contraction and relaxation of the sphincter.
ElectrotherapyElectrotherapy strengthens the muscles of the pelvic floor and the bladder with electrical pulses. This increases the ability to contract the pelvic floor and the bladder sphincter. Electrotherapy helps with targeted sensitization, activation and strengthening of the pelvic floor by functional improvement. Electrodes are inserted into the vagina or the anus (vaginal and anal electrodes must never be used simultaneously!) and a second electrode is attached on the body surface (see figure). It is also possible to attach two surface electrodes to stimulate the pelvic floor. Pelvic floor training is supported by the electrotherapy device.
Application is very easy and ideal for home use. Patients can use some electrotherapy devices at home according to the expert’s instructions (STIWELL med4).
- Combination of electrotherapy and biofeedback
Ideally, the electrotherapy device has a biofeedback function. The patient experiences to which extend they can contract their muscles. The patient sees even minute improvements and is thus motivated to continue exercising.
- Combination of electrotherapy and EMG-triggered electrostimulation
Electrotherapy devices with EMG-triggered stimulation function measure the activity of the pelvic floor muscles. Reaching a preset threshold by voluntary muscle contraction triggers electrostimulation and the electrical pulse completes the voluntary contraction.
In gynecology, electrotherapy in combination with biofeedback is particularly suitable for the treatment of uterine prolapse or connective tissue weakness, e.g. in cases of incontinence after childbirth.
Electrotherapy is ideal to treat stress incontinence, motor urge incontinence, mixed incontinence and reflex incontinence as a stand-alone method or in combination with other therapies.
In consultation with the doctor an individual drinking and micturition plan (exact fluid amount, choice of beverages, fixed toilet times) is established. Persons suffering from reflex incontinence can learn to voluntarily void their bladder before reflexive micturition.
Various drugs can help increase the strength of the urethral sphincters. They are used to support treatment of incontinence. Due to undesirable side-effects many drugs are not suitable for long-term administration.
Urinary incontinence can be treated with a variety of surgical interventions. Surgery should only be considered after consultation with a specialist when all non-invasive treatment options have been unsuccessful.
This article contains only general information and must not be used for self-diagnosis or self-treatment. This information does not replace medical advice.