The treatment for a bladder control problem depends on the cause of the nerve damage and the type of voiding dysfunction that results.
In the case of overactive bladder, your doctor may suggest a number of strategies, including bladder training, electrical stimulation, drug therapy, and, in severe cases where all other treatments have failed, surgery.
Your doctor may ask you to keep a bladder diary—a record of your fluid intake, trips to the bathroom, and episodes of urine leakage. This record may indicate a pattern and suggest ways to avoid accidents by making a point of using the bathroom at certain times of the day—a practice called timed voiding. As you gain control, you can extend the time between trips to the bathroom. Bladder training also includes Kegel exercises to strengthen the muscles that hold in urine.
Mild electrical pulses can be used to stimulate the nerves that control the bladder and sphincter muscles. Depending on which nerves the doctor plans to treat, these pulses can be given through the vagina or anus, or by using patches on the skin. Another method is a minor surgical procedure to place the electric wire near the tailbone. This procedure involves two steps. First, the wire is placed under the skin and connected to a temporary stimulator, which you carry with you for several days. If your condition improves during this trial period, then the wire is placed next to the tailbone and attached to a permanent stimulator under your skin. The Food and Drug Administration (FDA) has approved this device, marketed as the InterStim system, to treat urge incontinence, urgency-frequency syndrome, and urinary retention in patients for whom other treatments have not worked.
Drawing of a side view of the lower torso with an implanted electrical stimulator. A wire from the electrical stimulator is attached to the tailbone and delivers mild electrical pulses to the nerves that control bladder function. Labels point to the electrical stimulator, tailbone, nerves, and bladder.
A device can be placed under your skin to deliver mild electrical pulses to the nerves that control bladder function.
Different drugs can affect the nerves and muscles of the urinary tract in different ways.