11 doctors weighed in:

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

11 doctors weighed in
Dr. Denise Elser
Gynecology
4 doctors agree

In brief: 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.

In brief: 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.
Dr. Denise Elser
Dr. Denise Elser
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Dr. Thomas Byrnes
Family Medicine
2 doctors agree

In brief: Kegel exercises

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

In brief: Kegel exercises

Omt may be helpful if you have a musculoskeletal imbalance in your pelvis, it can affect your peovic floor.
Dr. Thomas Byrnes
Dr. Thomas Byrnes
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Dr. Scott Beard
Obstetrics & Gynecology - Urogynecology
1 doctor agrees

In brief: Tampon

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

In brief: Tampon

Can use the largest size tolerated while doing the vigorous activity, it can help for mild incontinence, if worsens will need surgery.
Dr. Scott Beard
Dr. Scott Beard
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Dr. Alfredo Nieves
Gynecology

In brief: 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.

In brief: 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.
Dr. Alfredo Nieves
Dr. Alfredo Nieves
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Dr. James Krick
Urology

In brief: 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.

In brief: 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.
Dr. James Krick
Dr. James Krick
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Dr. Scott Beard
Obstetrics & Gynecology - Urogynecology

In brief: Slings are main

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

In brief: Slings are main

They are the gold standard therapy.
The more common the leakage the more likely she should get treated.
Dr. Scott Beard
Dr. Scott Beard
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