Non-Surgical Treatments

NHS

Your treatment will depend on the type of urinary incontinence you have and the severity of your symptoms. If urinary incontinence is caused by an underlying condition, you may receive treatment for this alongside incontinence treatment. Conservative treatments, which do not involve medicines or surgery, are tried first. These include:

  • lifestyle changes
  • pelvic floor muscle training (Kegel exercises)
  • bladder training

After this, medicine or surgery may be considered. This page is about non-surgical treatments for urinary incontinence.

Lifestyle changes

A GP may suggest you make simple changes to your lifestyle to improve your symptoms, regardless of the type of urinary incontinence you have. For example, the GP may recommend:

  • reducing your intake of caffeine, which is found in tea, coffee and cola, as caffeine can increase the amount of urine your body makes
  • altering how much fluid you drink each day, as drinking too much or too little can make incontinence worse
  • losing weight if you are overweight or obese – use the healthy weight calculator to find out if you're a healthy weight for your height

NHS continence services

NHS continence services are centres staffed by specialist nurses, sometimes called continence advisers, and specialist physiotherapists. They should be able to diagnose your condition and start treating you. A GP can refer you to your local continence service and in some cases you may be able to refer yourself.

Pelvic floor muscle training

Your pelvic floor muscles surround the bladder and urethra (the tube that carries urine from your bladder out of your body) and control the flow of urine as you pee.

Weak or damaged pelvic floor muscles can cause urinary incontinence, so exercising these muscles is often recommended. A GP may refer you to a specialist to start a programme of pelvic floor muscle training. The specialist will assess whether you're able to squeeze (contract) your pelvic floor muscles and by how much.

Electrical stimulation

If you're unable to contract your pelvic floor muscles, using electrical stimulation may be recommended.

Bladder training

If you've been diagnosed with urge incontinence, one of the first treatments you may be offered is bladder training. Bladder training may also be combined with pelvic floor muscle training if you have mixed urinary incontinence. It involves learning techniques to increase the length of time between feeling the need to urinate and passing urine. The course will usually last for at least 6 weeks.

Incontinence products

While incontinence products are not a treatment for urinary incontinence, you might find them useful for managing your condition while you're waiting to be assessed or waiting for treatment to start helping.

Incontinence products include:

  • absorbent products, such as pants or pads
  • handheld urinals
  • a catheter (a thin tube that is inserted into your bladder to drain urine)
  • devices that are placed into the vagina or urethra to prevent urine leakage – for example, while you exercise

Medicine for stress incontinence

If stress incontinence does not significantly improve with lifestyle changes or exercises, surgery will usually be recommended as the next step.

However, if you're unsuitable for surgery or want to avoid an operation, you may benefit from an antidepressant medicine called duloxetine. This can help increase the muscle tone of the urethra, to help keep it closed.

Medicines for urge incontinence

If bladder training is not effective for your urge incontinence, a GP may prescribe a medicine called an antimuscarinic, also called an anticholinergic.

Antimuscarinics may also be prescribed if you have overactive bladder syndrome, which is the frequent urge to urinate that can happen with or without urinary incontinence.

If antimuscarinics are unsuitable for you, they have not helped urge incontinence, or have unpleasant side effects, you may be offered an alternative medicine called mirabegron.

Mirabegron causes the bladder muscle to relax, which helps the bladder fill up with and store urine. It usually comes as a tablet or capsule that you swallow once a day.

Medicine for nocturia

A low-dose version of a medicine called desmopressin may be used to treat nocturia, which is the frequent need to get up during the night to urinate, by helping to reduce the amount of urine produced by the kidneys.

Another type of medicine taken late in the afternoon, called a loop diuretic, may also prevent you getting up in the night to pass urine.

Diuretic medicine increases the production and flow of urine from your body. By removing excess fluid from your body in the afternoon, it may improve symptoms at night.

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