Can urinary incontinence be cured?
The short answer: yes, in many cases it can. The right treatment depends on the type of incontinence, its severity, and your personal goals, but most women get better, and many stop leaking completely.
It depends on the type
Treatment depends on which type you have:
Stress incontinence (leaking with coughing, sneezing, exercise) has some of the highest cure rates. Pelvic floor physical therapy resolves symptoms in many mild to moderate cases, and surgical procedures like the midurethral sling have high, durable success rates.
Urge incontinence (sudden, intense need to urinate with leaking) is managed rather than “cured” in the traditional sense, but most women can get excellent control. Treatments include behavioral therapy, medications, Botox injections into the bladder, sacral neuromodulation, and tibial neuromodulation.
Mixed incontinence (a combination of both) is usually treated by addressing the more bothersome type first.
Treatment options
For both types, lifestyle modifications (fluid management, weight optimization, avoiding irritants) and pelvic floor physical therapy are good starting points.
For stress incontinence, additional options include urethral bulking and the midurethral sling.
For urge incontinence, additional options include medications, Botox, sacral neuromodulation, and tibial neuromodulation.
The AUA guidelines don’t require step therapy (though your insurance might), so the right starting point depends on your symptoms and goals.
Why early treatment matters
Incontinence tends to worsen over time without treatment. The muscles and tissues that support bladder control can keep weakening. If you come in early, simpler treatments often work.
Dr. Stewart’s perspective
“I follow the AUA guidelines, which don’t require step therapy. Many of my patients are pleasantly surprised. They come in thinking they need surgery, and we’re able to get them better with physical therapy and lifestyle changes alone. But for some women, moving directly to Botox, sacral neuromodulation, or tibial neuromodulation may be the best first step for their goals.”
“The biggest barrier to treatment is the belief that nothing can be done, or that leaking is just a normal part of aging. Neither of these are true. We have excellent tools to help, and the sooner you seek evaluation, the more options we have.”
References
- ACOG Committee on Practice Bulletins—Gynecology, American Urogynecologic Society, Kenton KS, et al. Urinary Incontinence in Women (ACOG Practice Bulletin No. 155). Obstetrics & Gynecology. 2015. doi:10.1097/AOG.0000000000001148
- Kobashi KC, Albo ME, Dmochowski RR, et al. Surgical Treatment of Female Stress Urinary Incontinence: AUA/SUFU Guideline. The Journal of Urology. 2017. doi:10.1016/j.juro.2017.06.061
- Lightner DJ, Gomelsky A, Souter L, et al. Diagnosis and Treatment of Overactive Bladder (Non-Neurogenic) in Adults: AUA/SUFU Guideline Amendment 2019. The Journal of Urology. 2019. doi:10.1097/JU.0000000000000309
- Fleischmann N, Chughtai B, Plair A, et al. Urethral Bulking. Urogynecology. 2024. doi:10.1097/SPV.0000000000001548
- White N, Iglesia CB. Overactive Bladder. Obstetrics and Gynecology Clinics of North America. 2016. doi:10.1016/j.ogc.2015.10.002
- Sung VW, Borello-France D, Newman DK, et al. Effect of Behavioral and Pelvic Floor Muscle Therapy Combined With Surgery vs Surgery Alone on Incontinence Symptoms Among Women With Mixed Urinary Incontinence: The ESTEEM Randomized Clinical Trial. JAMA. 2019. doi:10.1001/jama.2019.12467
- Subak LL, Wing R, West DS, et al. Weight Loss to Treat Urinary Incontinence in Overweight and Obese Women. New England Journal of Medicine. 2009. doi:10.1056/NEJMoa0806375
← Learn more about Urinary Incontinence