Treatment options range from conservative treatment, behavioral therapy, bladder retraining, pelvic floor therapy, collecting devices (for men), fixer-occluder devices for incontinence (in men), medications and surgery. A 2018 systematic review update showed that both nonpharmacological and pharmacological treatments are effective for treating UI in non-pregnant women. All treatments, except hormones and periurethral bulking agents, are more effective than no treatment in improving or curing UI symptoms or achieving patient satisfaction. The success of treatment depends on the correct diagnoses. Behavioral therapy Behavioral therapy involves the use of both suppressive techniques (distraction, relaxation) and learning to avoid foods that may worsen<unk>  incontinence. This may involve avoiding or limiting consumption of caffeine and alcohol. Behavioral therapies, including bladder training, biofeedback, and pelvic floor muscle training, are most effective for improving<unk>  incontinence in women, with a low risk of adverse events. Behavioral therapy is not curative for<unk>  incontinence, but it can improve a person's quality of life. Behavioral therapy has benefits as both a monotherapy and as an adjunct to medications for symptom reduction. Avoiding heavy lifting and preventing constipation may help with uncontrollable urine leakage. Stopping smoking is also recommended as it is associated with improvements in<unk>  incontinence in men and women. Weight loss is recommended in those who are obese. Physical therapy and exercise Physical therapy can be effective for women in reducing<unk>  incontinence. Pelvic floor physical therapists work with patients to identify and treat underlying pelvic muscle dysfunction that can cease<unk>  incontinence. They may recommend exercises to strengthen the muscles, electrostimulation, or biofeedback treatments. Exercising the muscles of the pelvis such as with Kegel exercises are a first line treatment for women with stress incontinence. Efforts to increase the time between urination, known as bladder training, is recommended in those with urge incontinence. Both these may be used in those with mixed incontinence. Small vaginal cones of increasing weight may be used to help with exercise. They seem to be better than no active treatment in women with stress<unk>  incontinence, and have similar effects to training of pelvic floor muscles or electrostimulation. Biofeedback uses measuring devices to help the patient become aware of his or her body's functioning. By using electronic devices or diaries to track when the bladder and urethral muscles contract, the patient can gain control over these muscles. Biofeedback can be used with pelvic muscle exercises and electrical stimulation to relieve stress and urge incontinence. Time voiding while urinating and bladder training are techniques that use biofeedback. In time voiding, the patient fills in a chart of voiding and leaking. From the patterns that appear in the chart, the patient can plan to empty his or her bladder before he or she would otherwise leak. Biofeedback and muscle conditioning, known as bladder training, can alter the bladder's schedule for storing and emptying urine. These techniques are effective for urge and overflow incontinence A 2013 randomized controlled trial found no benefit of adding biofeedback to pelvic floor muscle exercise in stress<unk>  incontinence, but observing improvements in both groups. In another randomized controlled trial the addition of biofeedback to the training of pelvic floor muscles for the treatment of stress incontinence, improved pelvic floor muscle function, reduced<unk>  symptoms, and improved the quality of life. Preoperative pelvic floor muscle training (PFMT) in men undergoing radical prostatectomy was not effective in reducing<unk>  incontinence. Alternative exercises have been studied for stress<unk>  incontinence in women. Evidence was insufficient to support the use of Paula method, abdominal muscle training, Pilates, Tai Chi, breathing exercises, postural training, and generalized fitness. Devices Example of a foley catheter Individuals who continue to experience<unk>  incontinence need to find a management solution that matches their individual situation. The use of mechanical devices has not been well studied in women, as of 2014. * Collecting systems (for men) – consists of a sheath worn over the penis funneling the urine into a urine bag worn on the leg. These products come in a variety of materials and sizes for individual fit. Studies show that urisheaths and urine bags are preferred over absorbent products – in particular when it comes to ‘limitations to daily activities’. Solutions exist for all levels of incontinence. Advantages with collecting systems are that they are discreet, the skin stays dry all the time, and they are convenient to use both day and night. Disadvantages are that it is necessary to get measured to ensure proper fit, and in some countries, a prescription is needed. * Absorbent products (include shields, incontinence pads, undergarments, protective underwear, briefs, diapers, adult diapers and underpants) are the best-known product types to manage incontinence. They are widely available in pharmacies and supermarkets. The advantages of using these are that they barely need any fitting or introduction by a healthcare specialist. The disadvantages with absorbent products are that they can be bulky, leak, have odors and can cause skin breakdown due to the constant dampness. * Intermittent catheters are single-use catheters that are inserted into the bladder to empty it, and once the bladder is empty they are removed and discarded. Intermittent catheters are primarily used for<unk><unk>  (inability to empty the bladder), but for some people they can be used to reduce or avoid incontinence. These are prescription-only medical devices. * Different types of pessaries. These are inserted inside the vagina for support.Indwelling catheters (also known as foleys) are often used in hospital settings, or if the user is not able to handle any of the above solutions himself/herself (e.g. severe neurologic injury or neurodegenerative disease). These are also prescription-only medical devices. The indwelling catheter is typically connected to a urine bag that can be worn on the leg or hung on the side of the bed. Indwelling catheters need to be monitored and changed on a regular basis by a healthcare professional. The advantage of indwelling catheters is that because the urine is funneled away from the body, the skin remains dry. However, the disadvantage is that it is very common to incur<unk>  tract infections when using indwelling catheters. Bladder spasms and other problems can also occur with long-term use of indwelling catheters. * Penis clamp (or penis compression device), which is applied to compress the urethra to compensate for the malfunctioning of the natural<unk>  sphincter, preventing leakage from the bladder. This management solution is only suitable for light or moderate incontinence. * Vaginal pessaries for women are devices inserted into the vagina. This device provides support to the urethra which passes right in front of it, allowing it to close more firmly. Medications A number of medications exist to treat<unk>  incontinence including: fesoterodine, tolterodine and oxybutynin. These medications work by relaxing smooth muscle in the bladder. While some of these medications appear to have a small benefit, the risk of side effects are a concern. Medications are effective for about one in ten people, and all medications have similar efficacy. Medications are not recommended for those with stress incontinence and are only recommended in those with urge incontinence who do not improve with bladder training. Injectable bulking agents may be used to enhance urethral support, however, they are of unclear benefit. Surgery Women and men that have persistent incontinence despite optimal conservative therapy may be candidates for surgery. Surgery may be used to help stress or overflow incontinence. Common surgical techniques for stress incontinence include slings, tension-free vaginal tape, bladder suspension, artificial<unk>  sphincters, among others. The use of transvaginal mesh implants and bladder slings is controversial due to the risk of debilitating painful side effects such as vaginal erosion. In 2012 transvaginal mesh implants were classified as a high risk device by the US Food and Drug Administration. Urodynamic testing seems to confirm that surgical restoration of vault prolapse can cure motor urge incontinence. Traditional suburethral sling operations are probably slightly better than open abdominal retropubic colposuspension and are probably slightly less effective than mid-urethral sling operations in reducing<unk>  incontinence in women, but it is still uncertain if any of the different types of traditional suburethral sling operations are better than others. Similarly, there is insufficient evidence to be certain about the effectiveness or safety of single-incision sling operations for<unk>  incontinence in women. Traditional suburethral slings may have a higher risk of surgical complications than minimally invasive slings but the risk of complications compared with other types of operation is still uncertain. Laparoscopic colposuspension (keyhole surgery through the abdomen) with sutures is as effective as open colposuspension for curing incontinence in women up to 18 months after surgery, but it is unclear whether there are fewer risk of complications during or after surgery. There is probably a higher risk of complications with traditional suburethral slings than with open abdominal retropubic suspension. AMS 800 and ZSI 375 artificial<unk>  sphincters The artificial<unk>  sphincter is an implantable device used to treat stress incontinence, mostly in men. The device is made of 2 or 3 parts: The pump, cuff, and balloon reservoir connected
symptom of Urinary retention
symptom of Vomiting
symptom of Gastrointestinal bleeding
symptom of Bowel obstruction
symptom of Hypotension
symptom of Arrhythmia
symptom of Short bowel syndrome
symptom of Gastritis