There are many options today for controlling, reducing or eliminating the causes of incontinence, pelvic pain and other pelvic health concerns. Often, medications, therapy and nonsurgical procedures—alone or in combination—can relieve your symptoms and improve how your pelvic floor functions.

Depending upon your unique condition, Northwestern Medicine physicians* may recommend one or more nonsurgical treatment options.

Pelvic floor rehabilitation

Our licensed therapists create customized physical therapy plans that provide effective self-management tools and follow-up exercises that can be done in the privacy of your home. Through our services, you can decrease your pain, incontinence and emotional stress and increase your quality of life.

Your rehabilitation includes pelvic exercises (known as Kegel exercises) designed to train your pelvic floor muscles and increase your ability to hold and release urine and stool. Your therapists may help ensure you attain the best results using techniques such as biofeedback, electrical stimulation and manual therapy to optimize treatment, and improve your bladder and bowel function.

Medication

A variety of medications may be used to treat urinary incontinence, including:

• Topical estrogen: A low-dose topical application of estrogen may help rejuvenate and tone tissues in your urethra, reducing some of the symptoms of urinary incontinence.
• Imipramine (Tofranil®): This antidepressant is used to treat urgency and/or painful bladder syndrome.
• Anticholinergic drugs: These types of drugs, which include oxybutynin (Ditropan®), solifenacin (VESIcare®), fesoterodine (Toviaz®), tolterodine (Detrol®), darifenacin (Enablex®) and trospium (Sanctura®), may be used to treat overactive bladder.

Some medications that may be used to treat bowel incontinence include:

• Anti-diarrheals, such as Imodium®
• Laxatives, if chronic constipation is responsible for fecal incontinence
• Stool softeners, which can reverse the effects of constipation and impacted stool

Pain disorders, such as painful bladder syndrome or pelvic pain, may be treated with neuromodulators, muscle/joint injections and other medications, in conjunction with other treatments.

Interventional Therapies

Northwestern Medicine specialists look to a number of interventional therapies, designed specifically for women, to help treat incontinence, including:

• Pessary: This firm silicone ring is inserted into your vagina and designed to help support your bladder and/or urethra and prevent leakage.
• Bulking agents: Your physician may inject very small, non-absorbable materials into the tissue surrounding your urethra to help keep it closed and reduce urine leakage.
• Botox®: If you have overactive bladder, injections of Botox® into your bladder muscle may alleviate your incontinence.
• Anal bulking agents: The gel Solesta® is injected into the wall of your anal canal to bulk up the tissue and provide greater control.