Aging & Health A to Z
Care & Treatment
Stepped Approach to Treatment
The type of treatment your healthcare professional recommends will depend to some extent on the type of UI you have and what is causing it. Often, treatment is handled in a “stepped approach” that begins with addressing any medication or health problems, managing certain lifestyle factors, and “behavioral” treatments (like exercises). For example, if you have trouble walking, physical therapy may be recommended. Then, depending upon the success of these treatments, treatment may include other steps, such as medication or less frequently surgery.
Treating the Cause
If you have a health problem that causes or contributes to UI, your healthcare professional will recommend treatment for the problem. If one or more of the medications or supplements you are taking is a contributor, he or she will look for alternatives that don’t increase your risks of UI.
If you have urgency, stress, or mixed UI, your provider may recommend “bladder training” and pelvic muscle exercises. Bladder training involves practicing techniques that can, over the course of weeks, enable you to better control urination. Pelvic muscle exercises strengthen the muscles you use to control urine flow. Your healthcare professional may have you work with a nurse or physical therapist to learn the pelvic muscle exercises correctly.
If needed, if you have urgency UI your healthcare provider may prescribe a medication for UI, called an antimuscarinic agent. Antimuscarinic drugs are effective in treating urgency and mixed UI in some people. However, they can cause side effects, including dry mouth, blurry vision, dry eyes, and constipation, and less frequently confusion. No effective medications for stress UI are currently available in the United States. But there are surgical treatments for this and other forms of UI.
For an older adult who has dementia or cognitive problems as well as UI and is in the care of a caregiver, a healthcare professional may recommend a treatment called “prompted voiding.” In keeping with the treatment, the caregiver monitors the patient, to determine when he or she needs to use the toilet and encourages him or her to say or indicate when he or she needs to urinate. The caregiver prompts the patient to use the toilet on a regular schedule—usually every two to three hours during the day. This treatment has been shown to be successful with UI patients who have cognitive limitations.
If these treatments aren’t completely effective, your healthcare professional may refer you to a specialist such as a gynecologist, urologist, or a geriatrician for further evaluation. In the meantime, if you need to use absorbent pads and protective undergarments, be sure to change them frequently so that your skin does not become irritated.
Updated: October 2014
Posted: March 2012