Treatment for incontinence depends on the type of incontinence, the severity of the problem and the underlying cause. Often, a combination of treatments is used and most people treated for incontinence experience improvement.

Treatment options can be divided into four categories – behavioral techniques, medications, medical devices and surgery. Some behavioral techniques include:

• Dietary changes. Certain foods and beverages, such as chocolate, coffee, tea, alcohol and carbonated beverages (e.g., soda), can cause incontinence by irritating the bladder. They may also contain caffeine, which is a diuretic (increases the rate of production of urine).
  
  
• Weight loss. Extra weight places pressure on the bladder and surrounding muscles, weakening them and allowing urine to leak.
  
  
• Pelvic muscle exercises. Also called Kegel exercises, they are simple exercises to strengthen the muscles that help control urination, the urinary sphincter and pelvic floor muscles. Multiple studies have demonstrated the effectiveness of Kegels for women with urinary incontinence. However, the usefulness of Kegel exercises for men has not been scientifically proven.
  
  
• Timed urination or bladder training. These are two techniques to help train the bladder to hold urine better. Timed urination involves using the toilet on a routine, planned basis rather than waiting for the urge to urinate. Bladder training involves learning to delay urination after the urge occurs. This technique is often used in the geriatric population. 

When behavioral techniques alone are not successful in treating incontinence, medications may be used to suppress bladder muscle activity. They include:

• Antispasmodic drugs. Prescription medications that decrease muscle spasms and calm an overactive bladder (OAB). They can be effective in controlling incontinence. However, one side effect of this medication is dry mouth, which may cause a patient to drink more water thereby producing more urine and eventually worsening incontinence.
  
  
• Prostate medications. Drugs used to treat male urinary incontinence due to enlarged prostate. Two classes of medications are used. The first are alpha blockers, which relax the muscle of the prostate and allow for smooth urine flow. The second are 5-alpha reductase inhibitors, a class of drugs that help reduce the size of an enlarged prostate.
  
  
• Antibiotics. Medications that kill bacteria. Incontinence caused by a urinary tract infection (UTI) can be successfully treated with antibiotics.
  
  
• Hormone replacement therapy (HRT). Medications that replace female hormones that are no longer produced in adequate quantities after menopause. These medications are primarily used to relieve menopause-related symptoms. After menopause, a woman’s body produces less of the hormone estrogen, which can cause changes in the skin lining the urethra and vagina and contribute to the development of incontinence. Therefore, HRT is sometimes prescribed to reverse these changes and treat incontinence in postmenopausal women. However, several studies have found that HRT may increase the incidence of incontinence in postmenopausal women. Most experts no longer recommend it for the treatment of urinary incontinence.

If behavioral techniques and medications are ineffective in treating incontinence, some medical devices and procedures may help the condition. These include:

• Urethral insert. A small device available by prescription that a patient inserts into the urethra to prevent urine from leaking. It works best with women who experience predictable incontinence during certain activities, such as playing tennis. The insert is removed before urination and reinserted afterwards.
  
  
• Pessary. A stiff ring inserted into the vagina by a physician where it presses against the wall of the vagina and nearby urethra. The pressure helps to hold up the bladder and reduce leakage. It must be removed periodically for cleaning. A pessary is usually worn during the day and removed at night.
  
  
• Catheterization. A procedure for releasing urine from the bladder. A urinary catheter is a small tube inserted by a physician or patient through the urethra into the bladder to drain urine. Catheters can be used periodically or at all times. If it is continually used, the tube is connected to a bag that can be attached to the leg.
  
  
• Injection of bulking materials. Bulking materials, such as animal or human collagen, are injected through a needle into tissues around the urethra. Collagen is the fibrous protein found in skin, cartilage, bone and other connective tissue. The injection adds bulk and helps the urethra to remain closed, reducing incontinence. The procedure is done with minimal anesthesia and typically lasts about two to three minutes. It must be repeated every six to 18 months because the bulking agents do not remain effective over time. There are several new types of bulking agents being studied that may be more effective for longer periods. Also, they do not present the same problem with allergies or sensitivity to collagen that can exist with other products.
  
  
• Urine seal. A small foam pad that is placed by a patient over the opening of the urethra. The pad seals itself against the body, preventing leakage. It is removed and discarded after urination and a new seal is inserted.
  
  
• Dryness aids. Pads or adult incontinence briefs designed to absorb urine. Though they do not cure incontinence, they can be useful in managing episodes until the underlying condition causing incontinence can be resolved. They can be purchased at drug stores and medical supply stores.

If medical and behavioral treatments do not work, surgical procedures may be used to treat incontinence. These may include:

• Sacral nerve stimulation. A small device called a sacral nerve stimulator is implanted under the skin in the abdomen. A wire from the device is connected to a sacral nerve, a nerve involved in bladder control that runs from the lower spinal cord to the bladder. Through the wire, the device emits electrical pulses that control bladder and pelvic floor contractions.
  
  
• Sling procedure. A strip of tissue or synthetic material is surgically attached below the urethra to act like a hammock, compressing the urethra to prevent leaks. Following sling procedures, patients are able to control when urine is released. Sling procedures are the most popular surgery for women experiencing incontinence and are also available for men.
  
  
• Artificial sphincter. An implanted device used to control urethra opening in men with urinary incontinence. The patient triggers release of urine using a pump implanted into his scrotum.

In addition, there are other more invasive surgeries that can be done abdominally or laparoscopically to correct urinary incontinence. In conditions of prolapse, other surgeries may be used along with pelvic floor reconstruction to correct the problem.