Many women delay seeking medical care until their symptoms are so severe that they need surgery. In the meantime, they use pads to soak up the urine. Pads or adult diapers may offer security, but they have drawbacks. For instance, they can bother the skin. These products should not be the first or only treatment tried for incontinence. They should only be used to make other treatments work better or when other treatments have failed. There are many options for treatment. It depends on the cause of your problem. Treatments include behavioral changes, medication, special devices, or surgery.

Behavioral Treatments
The goal of behavioral treatment is to help a woman know why leakage occurs and how to avoid it. It may include bladder retraining and pelvic muscle exercises. With bladder retraining, you will be taught about normal and abnormal voiding patterns. You will be told to void at set times whether or not you have the urge. You will be told about ways to help you ignore any urges to pass urine. One is distraction-thinking about other things. After a few weeks you should have fewer instances of leaking urine. This method can be a success in many cases. Pelvic muscle exercises such as Kegel exercises (see box) improve urine control in 40-75% of women who use them. Biofeedback might be used with this or other treatments to improve your response. Biofeedback is a process that tells you about your body functions. This helps you to gain control of these same functions.

Medication
Medications that help control muscle spasms can help prevent leakage. Other drugs strengthen the smooth muscle of the urethra and improve symp-toms. These medications may cause:

• Dry mouth
• Constipation
• Nausea
• Blurred vision
• Sleeplessness