The American College of Physicians (ACP) has released new guidelines for treating urinary stress incontinence and urge incontinence without surgery.
For women with stress urinary incontinence, kegel exercises are recommended. Kegels help strengthen the muscles and tissues that control urine flow.
For women with urge incontinence, the group suggested bladder training. This treatment involves going to the bathroom on a schedule. As bladder control is gradually regained, the interval between bathroom breaks is increased. For example, one may start out using the bathroom every hour, and later increase that interval to every two hours, and then every two and a half hours. The goal is to expand the bladder’s capacity and decrease the amount of bathroom trips and wetting accidents. If bladder training doesn’t work, the physicians recommend taking prescribed medication.
For those with mixed incontinence (both stress incontinence and urge incontinence), the physicians suggested a combination of kegel exercises and bladder training.
Women who are obese are also encouraged to lose weight and exercise, according to the guidelines.
“Physicians should utilize nondrug treatments as much as possible for urinary incontinence,” Dr. David Fleming, president of the ACP, said in a press release. “Although various drugs can improve UI and provide complete continence, adverse effects often lead many patients to stop taking their medication.”
Fleming also strongly encouraged physicians to have an open conversation with their patients about symptoms of urinary incontinence. The condition affects millions of women in the United States, but is often underreported because patients feel embarrassed and ashamed.
The new ACP guidelines, titled “Nonsurgical Management of Urinary Incontinence in Women,” were published Sept. 16 in Annals of Internal Medicine.