Controlling or relieving incontinence depends on the type of incontinence and its underlying cause. Here are some general approaches, grouped by type of intervention, to help manage and alleviate incontinence :
1. Lifestyle modifications:
- Pelvic floor exercises (Kegel): These exercises strengthen the pelvic floor muscles, which support the bladder and urethra. They are particularly effective for stress incontinence and can also help in cases of urge incontinence.
- Fluid management: Reducing fluid intake before sleep and avoiding diuretic drinks (such as coffee, alcohol, and soda) can decrease the frequency of incontinence episodes.
- Weight management: Weight loss can reduce pressure on the bladder and pelvic muscles, helping to relieve stress incontinence.
- Avoid bladder irritants: Reduce or eliminate foods and beverages that can irritate the bladder, such as spices, citrus fruits, and artificial sweeteners.
2. Behavioural therapies:
- Bladder retraining: This method involves establishing a urination schedule to retrain the bladder to hold urine for longer periods of time, reducing the frequency of urinary leakage.
- Continence training: Involves planning regular toilet breaks to prevent accidents, especially in people with functional or cognitive incontinence.
- Biofeedback: A technique used to help patients become more aware of their pelvic muscles and improve their control.
3. Medicaments:
- Anticholinergics: Used to reduce overactive bladder and control symptoms of urge incontinence.
- Myrbegron: Drug that relaxes the muscles of the bladder, increasing its capacity and reducing the frequent urge to urinate.
- Topical estrogens: In postmenopausal women, the application of estrogen in the form of vaginal cream can strengthen the tissues around the urethra.
- Agents to strengthen stool: For fecal incontinence, medications that increase the consistency of the stool, such as fiber supplements, may be used.
4. Medical Devices:
- Pessaries: Devices inserted into the vagina to support the bladder, used primarily in stress incontinence in women.
- Intermittent catheters: For people who cannot empty their bladder completely, a catheter may be used to help control the symptoms of overflow incontinence.
- Nerve stimulation devices: Sacral nerve stimulation, for example, can help improve bladder control by regulating nerve signals.
5. Surgeries:
- Sling: A sling is placed under the urethra to support the bladder and reduce urine leakage, effective mainly for stress incontinence.
- Volumizing Substance Injection: Substances are injected around the urethra to improve sphincter closure and reduce leakage.
- Sacral Neuromodulation: An implanted device stimulates the nerves responsible for bladder function, helping to restore urinary control.
6. Care and protection:
- Absorbent pads: Adult diapers, panty liners, and absorbent panties can be used to manage leaks.
- Skin care: To avoid skin irritation caused by humidity, it is important to use barrier creams and maintain good hygiene.
7. Psychological approach and support:
- Behavioral therapy: For those whose incontinence is exacerbated by stress or anxiety, behavioral therapy may be helpful.
- Support groups: Participating in support groups can help manage the psychological impact of incontinence.
8. Medical consultation:
- Specialized Evaluation: Consult a urologist, gynecologist, or proctologist for a thorough evaluation and specific treatment recommendations.
- Regular follow-up: To adjust treatment based on progress or evolution of symptoms.
Each approach can be tailored to individual needs, and it is often necessary to combine multiple methods to achieve the best results in incontinence management.
