Often, the family doctor himself or herself can help: In the case of urge incontinence without a clear cause, medications such as antimuscarinics or sympathomimetics can relieve the suffering in many cases. In the case of inflammation, high blood pressure or stones in the urethra, the problem can also be remedied with medication, such as antibiotics or alpha-blockers. For benign enlarged prostate (BPH), minor surgery can help. If weakened pelvic floor muscles are the cause of stress incontinence, targeted pelvic floor training can bring improvement.
For more information on types, occurrence and causes of incontinence, see Incontinence.
Urodynamics for root cause analysis
If the cause of the incontinence remains unclear or initial therapy attempts are unsuccessful, a urodynamic examination may be required. This can be used to check the function of the bladder and sphincter by using probes to measure the pressure as the bladder fills and empties.
Depending on the results of the examination, various therapies are available: Conservative options such as indwelling catheters, self-catheterization or pelvic floor rehabilitation, medication, Botox injections, electrical stimulation or surgery as a last resort.
Various medications can be used for both stress and urge incontinence. Which medication may be helpful will be assessed after urodynamics have been performed.
In some cases, Botox injections may be used to treat certain medical conditions such as overactive bladder. Botox is injected into the bladder wall to reduce bladder muscle activity and relieve symptoms of overactive bladder. This may help reduce the frequency of urinary urgency and urinary incontinence.
Depending on the form of urinary incontinence, patients may be offered tape surgery, artificial sphincter (AMS-800® prosthesis) or a combination of both surgeries (ATOMS® prosthesis).
Ligament surgery or sling surgery for the treatment of incontinence is a surgical procedure. This usually involves placing a band of synthetic material or the body’s own tissue under the urethra or bladder to support and stabilize the urethra. The tape acts as a kind of “sling” that lifts the urethra and keeps it closed to prevent uncontrolled urine leakage.
Band surgery is often used for women with stress incontinence, in which there is uncontrolled leakage of urine during physical activities such as coughing, sneezing, laughing, or exercising. The procedure is usually minimally invasive, often using laparoscopic or robotic-assisted techniques, and typically requires only small incisions and a short recovery time.
An artificial sphincter is a medical implant. It is a device used to close the urethra or bladder outlet and prevent uncontrolled urine leakage. The artificial sphincter usually consists of a cuff or band placed around the urethra or bladder and connected to a control unit. The control unit can be controlled externally, for example by the patient himself or by a physician, to open or close the sphincter. Opening the artificial sphincter allows the patient to urinate, while closing the sphincter stops the flow of urine and prevents uncontrolled urine leakage.
Pelvic floor physiotherapy
If weakened pelvic floor muscles are the cause of stress incontinence, targeted pelvic floor training can bring improvement. Our pelvic floor physiotherapy can provide trained guidance here.
Here women can find tips for a strong pelvic floor: These tips and exercises strengthen the pelvic floor
Continence and Pelvic Floor Center
The certified continence and pelvic floor center combines the clinics of gynecology, urology, proctology/visceral surgery, gastroenterology, radiology and pain therapy, as well as physiotherapy and continence care consultation.
Treatment within the framework of clinical studies
Currently, a clinical trial for women with stress incontinence is being conducted at the Department of Urology to test a novel treatment option. The treatment option is cell therapy. This involves administering patients’ own muscle progenitor cells: a new treatment approach that could improve the symptoms of urinary incontinence.
For more information, see SUISSE MPC 2 study (muvon-studie.ch).