First, your doctor will obtain a detailed medical history and perform a physical examination, including a pelvic exam. Your urine will also be tested for signs of infection or other problems.

In addition, your doctor may recommend that you keep a voiding diary, recording your symptoms and the situations in which they occur. This may help narrow the cause of your problem, and aid in determining the best treatment.

What Treatments Are Available for Bladder Control Problems?

Treatment depends on the kind of bladder control problem you have. Your doctor may recommend some of the following lifestyle changes:

• Limiting caffeine consumption
• Strengthening pelvic muscles with Kegel exercises. These exercises strengthen your pelvic floor muscles. To do Kegel exercises, you squeeze and hold the pelvic muscles and then relax them. If you are unsure how to do Kegel exercises, ask your doctor for further instructions.
• Training the bladder to hold more urine
• Weight loss for obese women may result in improved bladder control.

If these simple treatments do not work, there are other options, including:

• Medication such as Detrol or Ditropan
• Biofeedback, which is a method of learning to voluntarily control certain body functions with the help of a special machine
• Electrical stimulation of pelvic muscles
• A device inserted in the vagina to hold up the bladder (pessary)
• A device inserted directly into the urethra to block leakage
• Surgery to lift a sagging bladder into a better position

Estrogen therapy is not FDA-approved for the treatment of incontinence but local estrogen therapy may help some women with bladder and vaginal symptoms.

What Doctor Do I See About My Bladder Control Problem?

Professionals who can help you with bladder control include:

• Your primary care doctor
• A gynecologist (a doctor who specializes in women's health care)
• A urogynecologist (an expert in women's bladder problems)
• A urologist (an expert in bladder problems)
• A nurse or midlevel provider such as a nurse practitioner or physician assistant
• A physical therapist