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TREATMENTS

Urinary Incontinence

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It can be hard to admit you have incontinence, which may make it more difficult to seek treatment. However, there are treatment options that may help improve bladder control and reduce symptoms of urinary incontinence.

Make an informed decision about treatment for urinary incontinence

 Talking to a doctor can help you understand which treatment option may be best for you and your specific type of incontinence – whether that’s lifestyle changes, minimally invasive therapy or surgery. 

Treatment options for male incontinence

Lifestyle changes

There are some lifestyle elements that contribute towards your male incontinence. Making lifestyle changes may help improve male incontinence. These include:

  • Losing excess weight
  • Cutting down on caffeine
  • Reducing your alcohol intake
  • Drinking plenty of water
  • Avoiding foods that might irritate your bladder, such as spicy food and citrus fruits

 

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Potential benefits

  • There is no need to take medications or have any procedures​
  • These are generally positive changes to your overall health​

 

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Potential risks and side effects

Many lifestyle changes may take time to have a positive impact on male incontinence.

 

Pelvic floor exercises

Your pelvic floor is the muscles located between your tailbone and pubic bone that provide support for your bladder and bowel. Pelvic floor exercises focus on strengthening these muscles to give you better control over urinating and bowel movements. This can help with male incontinence.

 

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Potential benefits

  • Improved bladder and bowel control 
  • Improved recovery after prostate surgery
  • Increased confidence and quality of life

 

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Potential risks and side effects

Pelvic floor exercises may not improve your bladder control enough to improve your quality of life.

 

Penile clamps

Penile clamps, also known as male mechanical devices or penile compression clamps, can be effective at reducing urine leakage with minimal risk of complications. These small, reusable devices are either adjustable or available in different sizes and are a popular alternative for men who don’t want to wear a sheath or absorbent product.

 

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Potential benefits

  • Prevent leakage by compressing the urethra
  • There is no need to take medications or have any procedures
  • Reusable

 

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Potential risks and side effects

  • Probably unsuitable for people with urge incontinence or who have poor memory or mental function, poor dexterity, no bladder sensation, or skin that is prone to damage
  • Penile clamps should be used with caution as they can reduce penile blood flow and cause pressure injury to the skin
  • Penile clamps are usually more beneficial when used in conjunction with other incontinence treatments

 

Male sling system

The male sling system is an internal device that supports the urethra and helps restore bladder control. This support for the surrounding muscles moves the sphincter back to its natural position where it helps keep the urethra closed during times of stress, such as coughing or lifting. It is usually recommended for men with mild to moderate urine leakage.

 

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Potential benefits

  • Visually undetectable since it is placed inside the body​
  • Most patients achieve continence immediately following the procedure​
  • You do not need to do anything to activate it

 

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Potential risks and side effects

Risks and side effects associated with male slings can include, but aren't limited to:

  • Stinging when you urinate 
  • Urinary retention 
  • Temporary perineal pain 
  • Failure of treatment 
  • Benefits of the treatment may decrease over time
  • Infection
  • Bleeding
  • Erosion
  • Device migration

Be sure to talk to your doctor about risks and benefits of male slings.

 

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Sacral neuromodulation

Sacral neuromodulation (SNM) is a therapy that uses electrical pulses to stimulate the sacral nerves, which help control the bladder. SNM may help people experiencing symptoms of overactive bladder (OAB), including urinary urgency, frequency and urge incontinence.

 

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Potential benefits

  • The device is placed inside the body and is not visible under clothing
  • Adjustable therapy that can be tailored to your symptoms
  • In a clinical study, 94% of patients were satisfied with their therapy and 93% experienced over 50% reduction in urinary urge incontinence symptoms at 2 years¹

 

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Potential risks and side effects

  • Pain or discomfort at the implant site
  • Infection
  • Device movement or malfunction
  • Changes in stimulation sensation that may feel uncomfortable
  • Need for additional procedures or device adjustments
  • Therapy may become less effective over time

 

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Artificial urinary sphincter

This is a long-term treatment option recommended for people with moderate to severe incontinence. It mimics the function of a healthy sphincter by placing a pump into your scrotum. When you need to urinate, you simply squeeze and release the pump to release urine from your bladder.

 

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Potential benefits

  • Visually undetectable since it is placed inside the body
  • Mimics the function of a normal, healthy sphincter so you can urinate at will
  • More than 90% of surveyed men said they would have an artificial sphincter placed again and 94% would recommend the device to a friend or family member1,2

 

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Potential risks and side effects

  • Scrotal haematoma characterised by the sudden onset of pain and swelling in the scrotum
  • The pump can move inside your body
  • Local irritation at the wound site and/or a foreign body response may occur
  • Tissue responses to the implant could include extrusion, erosion through the urethra or other surrounding tissue, migration from the desired location, fistula formation, and inflammation
  • Unintended damage to muscle, tissue, nerves or vessels
  • Infection
  • Urinary retention
  • Pain/soreness
  • Device malfunction

 

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Treatment options for female incontinence

Lifestyle changes

Certain lifestyle habits may contribute to urinary incontinence symptoms. Making small lifestyle changes may help improve bladder control and reduce leakage episodes. These can include:

  • Losing excess weight
  • Cutting down on caffeine
  • Reducing your alcohol intake
  • Drinking plenty of water
  • Avoiding foods that might irritate your bladder, such as spicy food and citrus fruits

 

Checkmark icon

Potential benefits

  • There is no need for medications or procedures
  • These are generally positive changes for your overall health

 

Information icon

Potential risks and side effects

  • Lifestyle changes may take time before symptoms improve
  • Lifestyle changes alone may not improve symptoms enough to significantly impact quality of life

 

Pelvic floor exercises

Your pelvic floor muscles support the bladder, bowel and uterus. Pregnancy, childbirth, ageing and other physical changes can weaken these muscles over time. Pelvic floor exercises focus on strengthening the pelvic floor muscles to help improve bladder control and reduce urine leakage.

 

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Potential benefits

  • Improved bladder control
  • May help reduce urine leakage episodes
  • Non-surgical treatment option
  • Increased confidence and quality of life

 

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Potential risks and side effects

  • Pelvic floor exercises may not improve your bladder control enough to improve your quality of life.
  • Results may take time and require consistency with exercises.

 

Urethral bulking agents 

A urethral bulking agent is a minimally invasive and long-lasting treatment option for women with stress urinary incontinence (SUI). A soft, water-based gel is injected into the wall of the urethra to help restore its natural closing function and reduce bladder leaks during activities such as coughing, laughing, sneezing or exercise.

 

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Potential benefits

  • Designed to provide long-lasting symptom relief, with 64% of women in one study choosing urethral bulking therapy over other SUI treatment options2
  • The procedure can be performed in an office setting or as an outpatient procedure
  • Short procedure time, typically around 20 minutes under local anaesthetic​

 

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Potential risks and side effects

  • Pain during urination
  • Urinary tract infection
  • Difficulty emptying the bladder immediately following the procedure
  • Blood in the urine
  • Long-term risks include difficulty urinating, abscess, scarring of the urethra, and urinary urgency

 

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Sacral neuromodulation

Sacral neuromodulation is a therapy that uses electrical pulses to stimulate the sacral nerves, which help control the bladder. A small device is implanted under the skin in the upper buttock area to help improve communication between the brain and the bladder. It may help reduce symptoms of overactive bladder (OAB), including urinary urgency, frequency and urge incontinence.

 

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Potential benefits

  • The device is placed inside the body and is not visible under clothing
  • Adjustable therapy that can be tailored to your symptoms
  • In a clinical study, 94% of patients were satisfied with their therapy and 93% experienced over 50% reduction in urinary urge incontinence symptoms at 2 years¹

 

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Potential risks and side effects

  • Pain or discomfort at the implant site
  • Infection
  • Device movement or malfunction
  • Changes in stimulation sensation that may feel uncomfortable
  • Need for additional procedures or device adjustments
  • Therapy may become less effective over time

 

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Find out more about SNM therapy   

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Artificial urinary sphincter

This is a long-term treatment option recommended for women with more severe stress urinary incontinence. It mimics the function of a healthy sphincter by helping keep the bladder neck closed until you wish to urinate. The device is fully implanted inside the body and operated using a small pump placed in the outer labia. When you need to urinate, you simply press and release the pump to allow urine to flow from your bladder.

 

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Potential benefits

  • Visually undetectable since it is placed inside the body
  • Mimics the function of a normal, healthy sphincter so you can urinate at will
  • Many patients experience significant reduction or resolution of urine leakage once the device is activated

 

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Potential risks and side effects

  • Infection
  • Pain or discomfort
  • Urinary retention
  • Difficulty operating or activating the device
  • Device movement or malfunction
  • Tissue erosion or inflammation around the implant
  • Bleeding or swelling
  • Recurrent incontinence

 

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Your doctor can help you to discover the cause of your incontinence and recommend treatment options for you to try.

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Frequently asked questions about incontinence

There are many different factors that can cause urinary incontinence including advancing age, an enlarged prostate and prostate cancer treatment. Identifying the cause of your incontinence will help identify appropriate treatment options. 

Incontinence is a very common side effect of some types of prostate cancer treatment, but every patient responds differently. You can always speak to your urologist about your concerns.

While there are some positive lifestyle changes that could improve your incontinence symptoms – such as losing weight and cutting back on alcohol and caffeine – there is no guarantee that these will resolve your bladder issues. Your urologist will be able to propose treatment options that can help restore your bladder control and help improve your quality of life.

There are several promising long-term treatment options for male incontinence, including artificial urinary sphincters, male sling system and sacral neuromodulation therapy. Some treatments require surgery, while others are minimally invasive, and your urologist can help you decide which option may be right for you depending on the type and severity of your symptoms.

There are several promising long-term treatment options for female incontinence, including urethral bulking agents, artificial urinary sphincters and sacral neuromodulation therapy. Some treatments are minimally invasive, while others require surgery. Depending on the type and severity of your symptoms your gynaecologist can help recommend the best treatment option.

References:

1. Pezzella A, McCrery R, Lane F, et al. Two-year outcomes of ARTISAN-SNM study for the treatment of urinary urgency incontinence using the Axonics rechargeable sacral neuromodulation system. Neurourol Urodyn. 2021

2. Dwyer et al., "Voice your choice": A study of women's choice of surgery for primary stress urinary incontinence. International Urogynecology Journal (2020) 31:769-777

CAUTION: The law restricts these devices to sale by or on the order of a physician. Indications, contraindications, warnings, and instructions for use can be found in the product labelling supplied with each device or at www.IFU-BSCI.com. Products shown for INFORMATION purposes only and may not be approved or for sale in certain countries. This material not intended for use in France. This material is for informational Purposes only and not meant for medical diagnosis. This information does not constitute medical or legal advice, and Boston Scientific makes no representation regarding the medical benefits included in this information. Boston Scientific strongly recommends that you consult with your physician.

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