Treatment Overview

Mechanical devices may be used to manage different types of urinary incontinence.

Stress incontinence

• Pessary: This rubber device is inserted into the upper vagina where it touches the cervix. The pessary presses on the urethra through the vaginal wall and holds up the bladder neck and uterus, if present. It may also pinch the urethra closed to help retain urine in the bladder. It is usually not necessary to remove the pessary to urinate. Normal bladder contractions can usually force urine out through the pinched-off urethra.
• Urethral insert: A thin, flexible tube that is solid rather than hollow (like a catheter) is placed into the urethra to block the leakage of urine. Many women find these devices uncomfortable.
• External urethral barrier: A self-adhesive patch or a cap is placed over the urethral opening to block the leakage of urine.

Overflow incontinence

A thin, flexible tube (catheter) that allows urine to drain out is inserted into the bladder through the urethra. Different types of catheters exist for use by women with urinary incontinence.

• Intermittent self-catheterization: A woman inserts a clean catheter when it is necessary to urinate, usually 3 or 4 times a day.
• Indwelling Foley catheter: A catheter remains in place continuously. This type of catheter has a balloon on one end that is inflated with sterile water once that end is inside the bladder. The inflated balloon prevents the catheter from slipping out. Urinary tract infections are more likely to occur with long-term use of an indwelling catheter than with intermittent self-catheterization.

What To Expect After Treatment

This section is not applicable to this treatment.

Why It Is Done

Mechanical devices may be used to manage overflow incontinence or stress incontinence. They may also be used to manage severe incontinence that cannot be treated with medications or surgery.

How Well It Works

These devices do not cure urinary incontinence but allow the woman (or a caregiver) to manage incontinence and to avoid releasing urine.

These devices generally are effective in managing urinary incontinence. However, some women find the devices uncomfortable or painful and stop using them.

Risks

Using a catheter or urethral insert increases the risk of:

• Urinary tract infection.
• Damage to the urethra.
• Skin irritation.

Using pessaries increases the risk of damaging the:

• Vaginal wall.
• Urethra.

What To Think About

Use of mechanical devices is under your control and can be designed to fit into your lifestyle.

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