What can be done for stress incontinence in older women? is tx indicated if only vigorous activity results in leaks and not everyday activity?

Kegel exercises: Try kegel exercises. Omt may be helpful if you have a musculoskeletal imbalance in your pelvis, it can affect your peovic floor.

Tampon: Can use the largest size tolerated while doing the vigorous activity, it can help for mild incontinence, if worsens will need surgery.

Many choices: Kegels (best is course of pelvic floor physical therapy), vaginal pessary (placed by gyne or urogyn), periurethral injection (office procedure for severe form of stress incontinence), or surgery. Minimally invasive sling, under local anesth, can be performed on women of all ages w/low risk. Incontinence does not need to be severe to deserve treatment.

Slings are main: They are the gold standard therapy. The more common the leakage the more likely she should get treated.

Stress incontinence: Treatment of sui is only indicated when the patient feels something must be done. I find that kegel exercises only help the mildest of leakage. Many older women who don't want incisional surgery, opt for peri-urethral bulking agents. Unlike slings, this actually can be done as an office procedure under local anesthetic.

Several treatments: SUI is the involuntary loss of urine that is socially unacceptable to the patient. So if you have to wear pads, carry a change of cloth, not able to exercise because of the incontinence you should have proper evaluation. Treatment could be conservative ie pessary, physical therapy, to surgical. The surgical treatment will depend on the physical findings, ie- sling, anterior repair, bulking agents.