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Therapy for urinary incontinence is one of the most effective ways to treat urine leakage and overactive bladder. With behavioral therapy for urinary incontinence you can strengthen your pelvic muscles in several ways, both with and without the need for any special devices. Bladder training is also suggested as a way to gain control over urine leakage. One advantage of behavioral therapy for incontinence is that you can use more than one at a time, and they all complement use of medications.
- Kegel exercises are exercises that help strengthen the pelvic floor muscles and urethra, which in turn can support the bladder opening to prevent leakage. You can do these exercises while watching television, sitting in a chair, standing in line…and no one will even know you are doing them. Kegel exercises involve squeezing the muscles you would use if you were trying to stop from passing gas. For best results, Kegel exercises should be done daily, at least 3 to 4 sets of 8 to 12 contractions for at least eight weeks.
- Biofeedback. When used along with Kegel exercises, biofeedback has been shown to help people better control and become more aware of their pelvic muscles. In fact, use of biofeedback can help men fight urinary incontinence even before they undergo a prostatectomy, which can cause urine leakage. Research shows that men who participated in preoperative biofeedback training regained urinary continence at an average of 3.5 months compared with longer than 6 months among men who didn’t learn biofeedback before surgery. Among men with urinary incontinence who have chosen biofeedback along with pelvic floor muscle exercises and/or electrical stimulation after prostatectomy, urinary incontinence improves significantly and improvement is achieved faster than among men who do not use this form of behavioral therapy for incontinence.
- Pelvic-floor electrical stimulation. This treatment requires use of a device that delivers very mild electrical pulses to stimulate muscle contractions in the pelvic floor. You can do the therapy yourself at home using the electrostimulation device with an exerciser that is inserted into your rectum. A control device allows you to determine the amount of stimulation. Electrical stimulation can be used along with Kegel exercises.
- Bladder training. This is a technique in which you learn how to resist your urge to void and gradually extend the time between voiding. Bladder training may also include scheduled toileting (going to the bathroom at predetermined times, even if you don’t feel like you need to void), keeping a diary of your urination and leakage episodes, and Kegel exercises.
Research shows that a behavioral therapy for incontinence program, which combined pelvic floor muscle training, biofeedback, bladder training, and pelvic floor stimulation, reduced the number of urinary incontinence events by 55% among men who still had urinary incontinence 1 to 17 years after prostatectomy. Among this group, 16% achieved complete urinary continence. A reduction in urinary incontinence was only 24% among men who had no behavioral therapy. Therefore, men who are still experiencing urinary incontinence a year or more after prostatectomy can still improve their continence if they use behavioral therapy.
Goode PS et al. Behavioral therapy with or without biofeedback and pelvic floor electrical stimulation for persistent postprostatectomy incontinence: a randomized controlled trial. JAMA 2011 Jan 12; 305(2): 151-59
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