What stops urinary incontinence depends on the type and cause

Urinary incontinence is treatable, but the right approach depends on whether you leak with coughing and exercise (stress incontinence), have sudden urges you can't control (urgency incontinence), or both. Some people stop leaking through pelvic floor exercises alone. Others need medication, devices, or procedures. A few need surgery. The first step is understanding which type you have, because treating stress incontinence with urgency medication won't work.

Most people don't mention incontinence to their doctor because they assume it's normal aging or untreatable. It's neither. A primary care doctor or urologist can usually identify the type in one visit and explain what works for that specific pattern.

Key Takeaways

  • Pelvic floor exercises (Kegel exercises) stop or reduce stress incontinence in about 30 to 40 percent of people who do them consistently for at least three months.
  • Urgency incontinence often responds to medications like oxybutynin or mirabegron, which relax the bladder muscle or change how it signals the brain.
  • Lifestyle changes—limiting caffeine and alcohol, timing fluid intake, and scheduled bathroom trips—reduce leaking for many people regardless of type.
  • Devices like pessaries (for women) and urethral inserts (for men) physically support the urethra during activity and work immediately, though they require daily insertion and removal.
  • Procedures like nerve stimulation and injections are available when exercises and medication don't work, and surgery is an option after other treatments have been tried.

Pelvic floor exercises: how to do them and what to expect

Pelvic floor exercises strengthen the muscles that control urine flow. They work best for stress incontinence—leaking during coughing, sneezing, exercise, or laughing. To do them correctly, you need to identify the right muscles first. The easiest way is to stop the flow of urine midstream when you're on the toilet. The muscles you use are your pelvic floor muscles. Once you know what they feel like, you can exercise them anywhere, anytime.

The standard routine is to squeeze those muscles for three seconds, then relax for three seconds. Start with 10 repetitions, three times a day. Over weeks, work up to holding for 10 seconds and doing 30 repetitions. Consistency matters more than intensity. Most people see improvement after 8 to 12 weeks of daily practice, though some take longer. About 30 to 40 percent of people stop leaking entirely with exercises alone.

Many people do these exercises incorrectly—holding their breath, squeezing their buttocks, or tightening their abdomen instead. A pelvic floor physical therapist can watch you and correct your form, which significantly improves results. Ask your doctor for a referral, or search for "pelvic floor physical therapy" in your area. Some insurance plans cover it.

Medications that reduce urgency and frequency

Urgency incontinence—sudden, hard-to-control urges to urinate—responds well to medication. The most common are anticholinergics like oxybutynin, tolterodine, and darifenacin. These relax the bladder muscle so it doesn't contract unexpectedly. They come as pills, patches, or sprays. Side effects can include dry mouth, constipation, and blurred vision, though newer formulations cause fewer problems.

Mirabegron works differently—it relaxes the bladder muscle through a different pathway and may cause fewer dry-mouth side effects, though it can raise blood pressure slightly. Your doctor will choose based on your other health conditions and medications.

Medication typically reduces urgency incontinence by 40 to 60 percent. Some people stop leaking entirely; others leak less frequently or with less volume. It usually takes one to two weeks to notice improvement. If the first medication doesn't work or causes side effects, your doctor can try a different one—response varies widely between people.

Lifestyle changes that reduce leaking

Before or alongside other treatments, changing daily habits often reduces incontinence significantly. Caffeine and alcohol both irritate the bladder and increase urgency, so cutting back or eliminating them can help both types of incontinence. Some people find that limiting fluids in the evening reduces nighttime leaking.

Scheduled bathroom trips—going at set times rather than waiting for the urge—trains your bladder and reduces accidents. Start by going every two hours while awake, then gradually extend the time between trips. This works particularly well for urgency incontinence.

Weight loss reduces pressure on the bladder and can significantly improve stress incontinence. Constipation also worsens leaking by putting pressure on the bladder, so adequate fiber and water intake help. Smoking irritates the bladder and causes chronic coughing, both of which worsen incontinence.

Devices that provide immediate support

If exercises and medication aren't enough or you need immediate relief, devices can help. A pessary is a silicone or plastic ring that a doctor inserts into the vagina to support the urethra and bladder neck. It prevents leaking during activity and is removed each night. You insert and remove it yourself after the doctor fits you and shows you how. Pessaries work immediately and are reusable for months, though they require daily care and aren't suitable for everyone.

A urethral insert is a small, tampon-like device men or women can insert into the urethra before exercise or activity. It blocks urine flow and is removed before urination. These work immediately but must be inserted each time you anticipate leaking.

Absorbent products—pads, underwear, and protective garments—don't stop leaking but manage it. They range from thin panty liners to full protective underwear. Many people use them alongside other treatments while waiting for exercises or medication to take effect.

Procedures when conservative treatments don't work

If pelvic floor exercises, medication, and lifestyle changes don't reduce leaking enough, several procedures are available. Sacral neuromodulation uses a small implanted device (similar to a pacemaker) that sends electrical signals to the nerves controlling the bladder. It reduces urgency incontinence in about 60 to 70 percent of people who have it. The procedure requires testing first to see if you'll respond, then surgery to implant the device.

Botulinum toxin injections into the bladder muscle relax it and reduce urgency incontinence. The effect lasts three to six months, so injections must be repeated. This is typically reserved for people who can't tolerate medication or haven't responded to it.

Bulking injections add material around the urethra to increase closure pressure, helping with stress incontinence. These are less invasive than surgery but may need to be repeated over time as the material is gradually absorbed.

Surgery for stress incontinence when other options fail

Surgery is considered after exercises, medication, and devices have been tried and haven't worked well enough. The most common procedure is a mid-urethral sling, which uses a small piece of mesh or tissue to support the urethra and bladder neck. Success rates are high—about 80 to 90 percent of people have significant improvement or stop leaking entirely. The procedure takes 20 to 30 minutes and is often done as outpatient surgery.

Other surgical options include bladder neck suspension (lifting the bladder neck to restore its position) and urethral bulking procedures done surgically rather than by injection. Your urologist will discuss which approach fits your anatomy and goals.

Surgery carries risks like infection, bleeding, and temporary difficulty urinating, though serious complications are uncommon. Most people return to normal activity within two to four weeks. Surgery is typically recommended only after conservative treatments have been tried, because it's permanent and carries surgical risks.

When to see a doctor and what to expect

Start with your primary care doctor, who can rule out urinary tract infections, diabetes, and other conditions that cause incontinence. They can also prescribe medication or refer you to a urologist (for all types of incontinence) or urogynecologist (for women with stress incontinence).

At the appointment, your doctor will ask about when leaking happens, how often, how much, and what you're doing when it occurs. They'll ask about medications, caffeine and alcohol use, and how much it affects your daily life. A urinalysis rules out infection. Some doctors do a simple test called a post-void residual, which measures how much urine stays in your bladder after you urinate—a sign that your bladder isn't emptying fully.

More detailed testing (urodynamics, cystoscopy) is usually done only if the diagnosis is unclear or if surgery is being considered. Most people don't need these tests.

Frequently Asked Questions

Can incontinence go away on its own?

Some types improve with time—for example, incontinence after childbirth often improves within the first year. Temporary incontinence from a urinary tract infection stops once the infection is treated. But chronic incontinence doesn't resolve without treatment. The longer you wait, the more it affects daily life and confidence.

Is incontinence a normal part of aging?

Incontinence becomes more common with age, but it's not inevitable or untreatable. Many people in their 70s and 80s have no incontinence. If you develop it, it's worth discussing with your doctor rather than assuming it's just aging.

Will pelvic floor exercises make things worse?

No, but doing them incorrectly (squeezing the wrong muscles or holding your breath) won't help. If you're unsure whether you're doing them right, ask your doctor for a referral to a pelvic floor physical therapist, who can watch and correct your technique.

Can I use both medication and exercises at the same time?

Yes. Many people use both together and see better results than with either alone. Medication reduces urgency while exercises strengthen the muscles that support the bladder. Your doctor can recommend a combination approach.

What if I've tried everything and still leak?

Procedures like sacral neuromodulation and surgery are options after conservative treatments have been tried. Talk to a urologist about what's available for your specific type of incontinence and what results you can realistically expect.