Your treatment plan will depend on how severe your symptoms are, which is tied directly to how much they interfere with your life. There are three main treatments for urge incontinence: medication, lifestyle habit changes and surgery.
Medications. Several types of medications may be used alone or in combination to relax bladder contractions and help improve bladder function. These include “anticholinergic” drugs that relax the muscles of the bladder, antispasmodic drugs and, surprisingly, certain antidepressants because of their effect on the bladder muscle.
Lifestyle habits. Not drinking liquids isn’t a viable solution. Some specialists recommend drinking more water but at regular intervals throughout the day and in small amounts—under 1 cup at a time. Avoid large quantities at a time because this can stress the bladder. Part of this overall strategy is to sip between meals and to stop drinking at least two hours before bed.
Avoiding certain foods and beverages that seem to irritate the bladder may help, too. These include spicy and high-acid citrus foods and caffeine and carbonated sodas.
According to some studies, lifestyle choices, like smoking, could have a significant impact on both your urinary and sexual functions. Through the FINNO (Finnish National Nocturia and Overactive Bladder) Study, researchers surveyed more than 2,000 Finnish women, aged 18 to 79, about their smoking habits and urinary function. To show the prevalence of incontinence issues, among these women, 7.1 percent reported increased daytime frequency, 12.6 percent reported nocturia (waking up through the night to urinate), 11.2 percent had stress incontinence, 9.7 percent experienced a feeling of urgency and 3.15 percent had urge incontinence. After evaluating smoking habits among participants, the researchers found that current and former smokers had a 2.7 and 1.8 increased likelihood of urinary urgency respectively and a 3.0 and 1.7 times increased likelihood of increased daytime frequency compared with women who never smoked (they did not however find an association between current or past smoking and nocturia or stress incontinence).
Lead investigator Kari Tikkinen, MD, PhD, a urology resident and epidemiologist at Helsinki University Central Hospital in Finland believes smoking has a direct impact on urinary function, possibly due to the nicotine. “Nicotine affects the bladder and the brain and there are many other toxic compounds in tobacco that can affect urinary function,” he explained, adding that being a current smoker “almost triples your risk of having urinary urgency and increased daytime frequency.” Yet another reason to quit if you’re still lighting up.
Another lifestyle habit to try is called bladder retraining. After becoming aware of patterns of your incontinence episodes, you retrain your bladder to better store and empty urine properly by developing a schedule of times to go to the bathroom. According to the National Institutes of Health, one method is to force yourself to wait 1 to 1-1/2 hours between trips to the bathroom, despite any leakage or urge to urinate. As you become skilled at waiting, you gradually increase the length by the intervals by 1/2 hour until they’re spaced every 3 to 4 hours.
You may find it helpful to avoid activities that irritate the urethra and bladder, such as taking bubble baths and using harsh soaps in the genital area.
Surgery. In severe cases, certain surgical procedures can increase the storage ability of the bladder and decrease the pressure within it. The most frequently performed surgery is called augmentation cystoplasty and involves using a segment of the bowel to increase bladder size and allow the bladder to store more urine. As with any surgery, it carries possible complications that should be discussed with your urologist. A newer surgical option is sacral nerve stimulation and consists of implanting a unit that sends small electrical pulses to the sacral nerve to improve bladder function.
The future. Keep in mind that instant improvement is rare, and you’ll need perseverance and patience. You may also need to try different therapies, some at the same time, to try to reduce symptoms. But don’t put off getting treatment. Starting bladder retraining techniques early on may help reduce the severity of your symptoms.