Stress urinary incontinence can often be improved with treatment. Options range from pelvic floor exercises and physical therapy to electrical stimulation, magnetic chairs, urethral bulking, and surgery. The best choice depends on the severity of your leaks, what is causing them, and how invasive a treatment you are comfortable with.
Updated: September 3, 2026
Reviewed by: Dr. Adeena Reeham
If you leak urine when you cough, laugh, sneeze, exercise, lift something heavy, or jump on a trampoline, you may have stress urinary incontinence (SUI).
Despite the name, stress incontinence is not caused by emotional stress. Instead, it occurs when physical pressure on the bladder exceeds the ability of the pelvic floor muscles and urethra to keep urine contained.
Stress incontinence is especially common after pregnancy and childbirth, and may become more common with menopause and age-related changes, but urinary incontinence is not considered a normal or inevitable part of aging. It can affect women of all ages and ranges from occasional drops to more significant leakage.
Unlike overactive bladder (OAB), which is characterized by urgency and frequent trips to the bathroom, stress incontinence typically occurs during physical activity and movement.
The good news is that many effective treatment options are available.
For women with mild symptoms, simple lifestyle changes may help reduce leakage. Weight loss, smoking cessation, management of chronic cough, and treatment of constipation can all reduce pressure on the pelvic floor.
Pelvic floor physical therapy is often considered the first-line treatment for stress incontinence. A specialized therapist teaches exercises and techniques that strengthen and coordinate the pelvic floor muscles, improving support around the bladder and urethra.
Treatment may include exercises, breathing techniques, manual therapy, and education. Home exercises are usually part of the program.
Biofeedback devices help users learn how to properly contract their pelvic floor muscles. A sensor measures muscle activity and provides feedback through an app or display screen.
Many devices turn pelvic floor exercises into guided workouts or games, helping users understand whether they are performing exercises correctly.
These devices use a vaginal probe to deliver electrical stimulation to the pelvic floor muscles. The stimulation creates involuntary contractions that may help strengthen muscles over time.
Most women describe a tingling sensation and rhythmic muscle contractions.
External pelvic floor stimulation uses electrodes placed on the skin between the legs to activate the pelvic floor muscles without vaginal insertion.
The stimulation creates contractions similar to pelvic floor exercises, helping strengthen muscles that support bladder control.
Users typically feel rhythmic muscle contractions similar to performing Kegels.
Vibration-based devices use gentle mechanical stimulation combined with pelvic floor exercises. The goal is to enhance muscle recruitment and strengthening.
The device is inserted vaginally and delivers vibration during guided exercise sessions.
Magnetic chair treatments use electromagnetic fields to stimulate the nerves and muscles of the pelvic floor while the patient remains fully clothed. The stimulation produces repeated involuntary pelvic floor contractions without requiring the patient to perform Kegels voluntarily.
Patients sit on a specialized treatment chair during an office-based session and feel repeated pelvic floor contractions. Treatment is usually provided as a series of appointments rather than as an at-home therapy.
Clinical studies suggest that extracorporeal magnetic stimulation can improve stress urinary incontinence symptoms, leakage measures, and quality of life for some women. However, the evidence is mixed in quality. Systematic reviews have found substantial variation in study methods, treatment protocols, and outcomes, making it difficult to determine how magnetic chairs compare directly with other treatments or which treatment schedule is most effective.
An earlier AHRQ systematic review and network meta-analysis also included magnetic stimulation among nonsurgical treatments for urinary incontinence and found that comparative evidence was limited. More recent meta-analyses have reported beneficial results, but long-term outcomes and standardized treatment protocols remain less certain.
Bulking agents are injectable materials placed around the urethra to improve closure and reduce leakage.
The procedure is typically performed in an office or outpatient setting and usually takes less than an hour.
A mid-urethral sling is considered the gold standard surgical treatment for stress urinary incontinence. A small supportive sling is placed under the urethra to provide additional support during coughing, laughing, exercise, and other activities.
The procedure is typically performed as outpatient surgery with a recovery period measured in days to weeks.
These treatments deliver controlled heat energy to vaginal tissues with the goal of stimulating collagen remodeling and tissue tightening. Evidence for vaginal laser and radiofrequency treatments for stress urinary incontinence remains limited, and these approaches are not established treatments. Patients should discuss the potential benefits, uncertainties, and risks with a qualified clinician.
A device is inserted into the vagina during a short office procedure.
Stress urinary incontinence is highly treatable, and many women improve without surgery. Others may consider office-based procedures such as urethral bulking injections or surgical options such as sling procedures.
The best treatment depends on the severity of leakage, your lifestyle, your comfort with devices or procedures, and your personal goals.
Fortunately, there are more treatment options available today than ever before, allowing many people to return to exercise, travel, social activities, and daily life with greater confidence.
Conservative treatment is usually the first step. This can include pelvic floor muscle training, pelvic floor physical therapy, lifestyle changes, and devices that strengthen or support the pelvic floor. If conservative approaches do not provide enough improvement, women may consider office-based procedures or surgery.
Kegels may not work well if the wrong muscles are being used, contractions are too weak, exercises are not performed consistently, or the leakage is not primarily caused by pelvic floor weakness. Pelvic floor physical therapy can help confirm proper technique. Neuromuscular electrical stimulation is another option because it can activate pelvic floor muscles automatically rather than relying entirely on voluntary contractions.
Yes. Neuromuscular electrical stimulation can activate the pelvic floor muscles involved in bladder support and continence. Devices may deliver stimulation internally through a vaginal probe or externally through the skin. Elitone provides external, at-home neuromuscular electrical stimulation without vaginal insertion, allowing repeated pelvic floor contractions without requiring the user to perform each Kegel voluntarily.
Research suggests that extracorporeal magnetic stimulation can improve urinary incontinence symptoms and quality of life for some women. However, systematic reviews have found substantial variation in treatment protocols, study quality, and outcomes. Long-term effectiveness and how magnetic chairs compare directly with other treatments remain less certain. Magnetic-chair treatments also generally require multiple clinic visits and may involve substantial out-of-pocket cost.
Both approaches can produce involuntary pelvic floor contractions, but they deliver energy differently. Magnetic chairs use an electromagnetic field while the patient sits fully clothed in a clinic. Neuromuscular electrical stimulation uses electrical signals delivered through electrodes and may be provided through an internal probe or externally through the skin. Some electrical stimulation devices, including Elitone, are designed for treatment at home.
Not necessarily. Urethral bulking agents add volume around the urethra to help it close more effectively during coughing, exercise, or other activities that increase abdominal pressure. They are less invasive than sling surgery, but the effect may decrease over time and repeat injections may be necessary.
Surgery may be considered when stress incontinence significantly affects quality of life and conservative or less invasive treatments have not provided enough improvement. Midurethral sling surgery is one established surgical option, but the best choice depends on symptoms, medical history, previous treatments, personal preferences, and discussion with a qualified clinician.
Not always. Stress incontinence typically involves leakage with coughing, sneezing, exercise, or other increases in abdominal pressure, while urge incontinence involves a sudden strong need to urinate followed by leakage. Strengthening-oriented treatments are commonly used for stress incontinence, while urge incontinence may require bladder training, medications, bladder-calming stimulation, Botox, or nerve-based therapies. Mixed incontinence includes both types and may require treatment that addresses both components.
There is no single treatment that is best for every woman. The right option depends on the severity and type of leakage, whether pelvic floor weakness is present, previous treatments, comfort with internal devices or procedures, cost, convenience, and whether you prefer an at-home or office-based treatment. Many women start with conservative options before considering injections or surgery.
