Best Non Surgical Incontinence Treatments for You

A leaking bladder can change far more than a wardrobe choice. It can mean planning every outing around toilets, waking repeatedly overnight, avoiding exercise, or feeling less at ease with intimacy. Non-surgical incontinence treatment should be selected according to the type of leakage, contributing factors and individual circumstances.

Pelvic floor weakness may contribute to incontinence after childbirth, through menopause or following prostate treatment. Urinary incontinence is common, and treatment options depend on the type and underlying cause. You do not have to accept it as an inevitable part of ageing.

Start with the type of incontinence

“Incontinence” describes a symptom, not one single condition. Stress urinary incontinence causes leakage when pressure rises inside the abdomen, such as during a cough, laugh, lift, run or jump. It is frequently linked with reduced pelvic floor support.

Urge incontinence is different. It involves a sudden, difficult-to-control need to pass urine, sometimes followed by leakage before reaching the toilet. Some people have mixed incontinence, with both stress leakage and urgency. Men may experience leakage related to prostate enlargement, prostate surgery, nerve changes or pelvic floor dysfunction.

This distinction matters because the right treatment for stress leakage may not be the right treatment for bladder urgency. A clinician-led assessment can also help rule out causes requiring different care, including a urinary tract infection, prolapse, medication effects, constipation, blood in the urine or neurological symptoms.

How non-surgical incontinence treatments compare

Non-surgical treatment may be an appropriate first step for some forms of incontinence, depending on assessment. The most suitable approach depends on your symptoms, pelvic floor function, medical history, goals and preference for time commitment.

Supervised pelvic floor muscle training

Pelvic floor muscle training is a recognised first-line option for some forms of urinary incontinence. When performed correctly and consistently, they can improve support around the bladder and urethra. They are particularly useful for stress incontinence and may also help with urgency when combined with bladder training.

Some people are unsure whether they are contracting the correct muscles. Some bear down instead of lifting, tense their abdomen and buttocks, or do not train frequently enough to build strength. A pelvic health physiotherapist can assess technique and provide an individual programme. Supervised pelvic floor physiotherapy can provide assessment of technique and an individual exercise programme.

Bladder training and practical habit changes

For urgency and frequency, bladder training may be appropriate. It involves gradually increasing the time between toilet visits, using strategies to settle an urge, and reducing the habit of going “just in case”. A bladder diary can reveal patterns involving fluids, caffeine, alcohol, fizzy drinks and particular times of day.

Lifestyle changes are not a cure-all, and patients should not be told simply to drink less. Concentrated urine can irritate the bladder. Instead, the aim is sensible hydration, treatment of constipation, review of bladder irritants where relevant, and weight management when excess weight is contributing pressure to the pelvic floor. These measures may form part of a broader management plan where appropriate.

Vaginal pessaries and support devices

For some women with stress incontinence or prolapse-related symptoms, a fitted vaginal pessary may provide mechanical support to the bladder neck and vaginal walls. It can be useful for exercise, particular activities or ongoing management.

A pessary is not suitable for everyone, and fitting, comfort and follow-up matter. It may improve symptoms without strengthening the pelvic floor itself, so it is often used alongside pelvic floor rehabilitation rather than as the only treatment.

EMSELLA for pelvic floor strengthening

EMSELLA is a non-invasive chair-based treatment designed to stimulate the pelvic floor using high-intensity focused electromagnetic energy. During a fully clothed session, the chair produces repeated high-intensity pelvic floor contractions in a controlled clinical setting.

For suitable patients, this can be a practical option when leakage is linked to pelvic floor weakness, when home exercises have not delivered enough improvement, or when finding time for lengthy rehabilitation has been a barrier. Sessions are brief, require no recovery time and do not involve needles, medication or surgery.

EMSELLA is not a replacement for a medical assessment, nor is it a guaranteed cure for every form of incontinence. Clinical screening is required to determine whether pelvic floor strengthening is appropriate for the underlying cause of symptoms. At Advance Medical Therapies in South Yarra, treatment is consultation-led so that symptoms, clinical suitability and treatment goals can be assessed before treatment.

Medication and specialist care

While medication is not a surgical treatment, it is not always the preferred answer for people seeking a drug-free option. Certain medicines may reduce overactive bladder symptoms, but side effects can include dry mouth, constipation and other concerns. They generally do not address stress incontinence caused by weak pelvic floor support.

Persistent, severe or complex symptoms may need further investigation by a GP, continence specialist, urologist or gynaecologist. Surgery may be discussed in selected cases, particularly where conservative treatment has not helped enough. Considering non-surgical treatment first does not close the door on future options. It allows non-surgical options to be considered before surgery where clinically appropriate.

Choosing an appropriate treatment

Treatment should be matched to the condition, clinical circumstances and the person’s ability to follow the treatment plan. A postpartum woman who leaks when running may benefit from structured pelvic floor rehabilitation and clinician-guided strengthening. A menopausal woman with urgency, night-time waking and vaginal symptoms may need a broader assessment rather than pelvic floor treatment alone. A man experiencing leakage after prostate treatment may benefit from focused pelvic floor support, while also remaining under the care of his treating specialist.

When comparing options, consider whether the provider assesses your symptoms rather than selling a generic package, whether you understand the likely commitment involved, and how progress will be measured. Ask what changes are realistic, how many sessions or appointments may be needed, and what happens if your symptoms do not improve as expected.

Good care should also feel dignified. You should be able to discuss leakage, urgency, vaginal laxity or changes in sexual function without embarrassment or pressure. These concerns affect confidence, relationships, work and sleep. They deserve the same thoughtful clinical attention as any other health issue.

When not to wait

Arrange medical review promptly if incontinence begins suddenly, is accompanied by pain or burning, blood in the urine, recurrent infections, new weakness or numbness, bowel control changes, severe pelvic pain, or difficulty emptying the bladder. These symptoms may require investigation before any pelvic floor treatment begins.

It is also worth seeking assessment when leakage is becoming normalised. Wearing pads every day, avoiding a gym class, skipping a long drive or waking several times each night are not minor inconveniences if they are shrinking your life. A clinical assessment can help clarify the diagnosis and appropriate treatment options.

A private clinical consultation can help clarify possible causes and whether a non-surgical treatment option is appropriate.

Ready to take the next step?

Contact our team to arrange your Emsella consultation and discuss your symptoms, goals, and whether Emsella may be appropriate for you.

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