You may be able to minimize the effects of a leaky bladder or bowel through exercise and lifestyle changes. Behavioral techniques to control incontinence include:

• Bladder training: We teach you techniques to train your bladder to hold more urine for longer periods of time. You void on a specified schedule, which may mean delaying urination after you get the urge to go. After several weeks or months of increasing time between voids, you may not need to urinate as frequently.
• Bowel training: This concept is similar to bladder training, in which you try to have a bowel movement at the same time each day. Over time, your bowel movements may become more regular.
• Pelvic floor (Kegel) exercises: These exercises strengthen the muscles that control your bladder and bowel.
• Pelvic floor therapy: Our team of pelvic floor specialists offer rehabilitation services to strengthen the sling of muscles that supports your abdominal and pelvic organs and controls your bladder and bowels.
• Fluid and dietary changes: You may need to consume less alcohol, caffeine, acidic foods or less fluid overall.
• Healthy habits: Quitting smoking and losing weight can help minimize incontinence symptoms.

Some medications can help bladder muscles function more normally. These include:

• Anticholinergics: Subdue an overactive bladder
• Beta-3 Agonists: Help the bladder muscles to relax while increasing the amount of fluid the bladder can hold
• Alpha blockers: Help the bladder, neck and prostate muscles relax so men can more easily empty their bladders
• Topical estrogen: Supports areas around the urethra and vagina. It can be applied as a vaginal cream, suppository, ring or patch
• Botulinum toxin (Botox) injections: Helps bladder muscles relax

If lifestyle changes or medications don’t bring relief from incontinence, your provider may recommend a minimally invasive procedure. We provide the latest options, including:

• Bulking materials: Your provider injects synthetic substances into the tissue around the urethra (for urinary incontinence) or anus (for fecal incontinence). The material prevents leakage by helping keep the urethra or anus closed.
• Medical devices: Some devices can help women with urinary incontinence. A urethral insert goes in the urethra to prevent leakage. A pessary is a silicone ring inserted into the vagina that supports the urethra to avoid urine leakage.
• Sacral nerve stimulation: Your provider implants a small electrical transmitter, such as InterStim™ therapy, next to the sacral nerve and under the skin in the buttocks or low back. Similar to a heart pacemaker, the transmitter sends gentle, painless electrical impulses to the sacral nerve to regulate bladder and bowel activity.
• Self (intermittent) catheterization: You or a caregiver inserts a catheter (thin, hollow tube) into the bladder through your urethra. Urine drains out of the bladder through the tube and into the toilet. You may need to repeat this process several times a day.

If you need surgery to treat urinary or fecal incontinence, you can rest assured in the experience and expertise of the team at UVM Health. Our board-certified surgeons have specialized training in traditional and leading-edge treatments, including:

• Artificial urinary sphincter (AUS): Your surgeon places a small, fluid-filled ring around the urethra to keep it closed and alleviate urinary incontinence. When you need to urinate, you press a button under the skin that deflates the ring and opens the urethra. Men are more likely than women to use an AUS.
• Sling procedures: Providers use a sling made from mesh or your body’s tissue to hold up the bladder neck and urethra. This ensures the urethra stays closed to prevent urine leakage.
• Suspension procedures: The provider lifts the vagina so it can support the bladder neck and keep the urethra closed. These procedures help women with urinary incontinence due to pelvic organ prolapse.
• Rectal prolapse surgery: Fecal incontinence can happen when the rectum has stretched and protrudes from the anus. Returning the rectum to its normal position may alleviate this condition.
• Sphincteroplasty: Repairing a weakened or damaged anus can help treat fecal incontinence.