Treatment Options for Bladder and Bowel Leakage

By the GSMC team, medically reviewed by Dharam P. Mann, MD and Samir Jani, MD

Leaking urine, sudden urges to get to a bathroom, trouble emptying the bladder, or accidental bowel leakage are common, and many people wait years before mentioning them to a doctor. These problems are medical conditions, not a normal part of aging that you simply have to accept, and there are several treatment options.

Common types of bladder and bowel leakage

• Overactive bladder and urge incontinence: a sudden, strong need to urinate, going often, and sometimes leaking before reaching the bathroom.
• Stress urinary incontinence: leaking with a cough, sneeze, laugh or lift.
• Urinary retention: trouble starting urination or emptying the bladder completely.
• Fecal (bowel) incontinence: accidental leakage of stool or gas, sometimes with little warning.

First steps that may help

• Keep a 3-day bladder or bowel diary so you and your doctor can see patterns.
• Adjust fluids and limit caffeine, alcohol and carbonated drinks, which can irritate the bladder.
• Add fiber and manage constipation, which can affect both bladder and bowel control.
• Bladder training: gradually lengthen the time between bathroom trips.
• Pelvic floor physical therapy to strengthen and coordinate the muscles that support the bladder and bowel.
• Medicines for overactive bladder, prescribed by your doctor.

When first steps are not enough: neuromodulation

The bladder and bowel rely on nerve signals that pass through the sacral nerves in the lowest part of the spine. Neuromodulation therapies use mild electrical pulses to help those signals work more normally.

Sacral neuromodulation (InterStim™ and Axonics™)

Sacral neuromodulation may be an option for overactive bladder, non-obstructive urinary retention and fecal incontinence when other care has not helped enough. GSMC offers systems from two manufacturers, InterStim™ (Medtronic) and Axonics™ (Boston Scientific), each with rechargeable and recharge-free models. It happens in two steps: a short evaluation (trial) period while you keep a symptom diary, and, only if your symptoms improve, a small long-term device placed under the skin of the upper buttock. At GSMC, Dr. Mann and Dr. Jani perform both steps as minimally invasive outpatient procedures at Manchester Surgery Center in Whiting. Learn more, including a device comparison, on our sacral neuromodulation page and in our printable patient guide.

Tibial neuromodulation

Another approach stimulates the tibial nerve near the ankle, which connects to the same nerve pathways. See our tibial neuromodulation page.

Other specialist treatments

Depending on the cause, a urologist, urogynecologist or colorectal specialist may also discuss options such as bladder injections or surgical repairs. We are glad to coordinate with your other doctors.

When to see a doctor

Make an appointment if leakage or urgency affects your sleep, work, travel or social life, or if you have trouble emptying your bladder. Seek care right away if you suddenly cannot pass urine, or if new loss of bladder or bowel control comes with back pain, leg weakness or numbness in the groin area; call 911 or go to the emergency room.

Bladder and bowel care at GSMC

Consultations are available at all 7 GSMC offices in Ocean and Monmouth County: Whiting, Toms River, Brick, Barnegat, Manahawkin, Freehold and West Long Branch. Many plans, including Medicare, cover these treatments when criteria are met; we verify your benefits before scheduling. Read more on our bladder and bowel control page.

Call 732-202-3000 or request a consultation.

Frequently Asked Questions

Is bladder leakage a normal part of aging?

It is common, but it is not something you have to accept. Many treatment options exist, from lifestyle changes and pelvic floor therapy to medicines and neuromodulation.

Can bowel leakage be treated?

Yes. Diet changes, managing constipation or diarrhea, pelvic floor therapy and, for some people, sacral neuromodulation may help. A doctor can help find the cause.

What are InterStim™ and Axonics™?

They are two brands of sacral neuromodulation system, made by Medtronic and by Axonics (a Boston Scientific company). GSMC offers both. Each sends mild pulses to the sacral nerves to help the bladder and bowel work more normally, and you test it first before any long-term device is placed.

InterStim™ is a trademark of Medtronic. Axonics™ is a trademark of Axonics, Inc., a Boston Scientific company.

Medical disclaimer: This article is for general education only and is not medical advice. Please talk with your own doctor about your symptoms and treatment. Individual results vary.