New Guidelines for Treating Incontinence

Kegel exercises and bladder training may control urinary incontinence in women

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) The American College of Physicians (ACP) has updated its guidelines for treating urinary incontinence (UI), a fairly common medical issue facing women today.

The ACP is a professional organization for doctors and other specialists. After reviewing research on UI, the group released new treatment guidelines.

The new guidelines suggest treating UI with Kegel exercises and bladder training.

"Talk to a urologist about how to manage UI."

In a press release, ACP President David Fleming, MD, called UI a “common problem for women that is often underreported and underdiagnosed.”

UI affects women as they age, according to ACP research. Some 75 percent of women older than 75 have the condition — marked by an inability to hold urine.

Risk factors include pregnancy, pelvic floor trauma from vaginal delivery, menopause, hysterectomy and obesity, among others.

The new guidelines suggest bladder training, Kegel exercises to strengthen pelvic muscles, weight loss and exercise to combat UI.

Kegels work the muscle that controls urine flow. This can help with incontinence when laughing, coughing or sneezing.

Bladder training is a therapy that involves using the restroom on a set schedule. This can help with the loss of urine after feeling the need to urinate.

Dr. Fleming said the methods “are effective, have few side effects, and are less expensive than medications.”

"Physicians should utilize non-drug treatments as much as possible for urinary incontinence," said Dr. Fleming in a press release. "Kegel exercises for stress UI, bladder training for urgency UI, and Kegel exercises with bladder training for mixed UI are effective, have few side effects, and are less expensive than medications. Although various drugs can improve UI and provide complete continence, adverse effects often lead many patients to stop taking their medication."

"Physicians should take an active approach and ask specific questions such as onset, symptoms, and frequency of [UI],” he added. “It is estimated that about half of the women with incontinence do not report it to their doctor."

The new practice guidelines were published online Sept. 15 in Annals of Internal Medicine.

The ACP guidelines are based on a review of relevant research published from 1990 to 2013.

Review Date: 
September 11, 2014
Last Updated:
September 15, 2014