ABSTRACT
This chapter addresses the first group of individuals because their numbers are larger and the treatment modalities are oriented to patients themselves rather than a caregiver or an institutional environment. It describes the status of the major approaches to incontinence including behavioral treatments, pharmacologic treatments, electrical stimulation, surgical treatments, periurethral injection, and artificial sphincter devices. Behavioral treatments are a diverse group of therapies that modify stress, urge, or mixed urinary incontinence either by changing the patient's bladder habits or teaching new skills. Pharmacotherapy may also be combined with electrical stimulation or behavioral therapy. Urinary incontinence is the involuntary loss of urine. Periurethral injections are a new treatment innovation for severe stress urinary incontinence due to urethral insufficiency. Several studies have investigated the use of biofeedback to modify physiological responses in the treatment of urinary incontinence. Future research might also address the issue of combining pelvic muscle exercise with other therapies to enhance outcomes.
