If you’re leaking when you laugh, sneeze, exercise, or can’t make it to the toilet in time, you’re not alone. Incontinence affects up to 1 in 3 Australian women at some point in life. Yet too many people suffer in silence, thinking it’s normal after childbirth or ageing.
The good news? There is a wide range of evidence-based, non-surgical treatment options — and they’re more accessible than ever.
Let’s break down what’s available, what works, and how to get support.
What Kind of Incontinence Are We Talking About?
Incontinence isn’t one-size-fits-all. Knowing the type you have is the first step to guiding the right treatment:
- Stress Incontinence: Leaking with physical activity like coughing, sneezing, or lifting.
- Urge Incontinence: A sudden, intense urge to go, with leakage before you make it.
- Mixed Incontinence: A combination of both stress and urge symptoms.
Pelvic Floor Physio: First-Line and Often Life-Changing
A qualified pelvic floor physiotherapist is often the best place to start — and it’s backed by strong evidence.
Pelvic floor muscles support the bladder, bowel, and uterus. A physio can assess your function and teach you how to strengthen or retrain these muscles correctly (spoiler: many people are doing pelvic floor exercises wrong!).
They also help with bladder training techniques to improve control and reduce urgency.
According to the Continence Foundation of Australia and RANZCOG, pelvic floor physiotherapy should be the first line of treatment for stress incontinence — and can significantly reduce symptoms without surgery or medication, though pelvic floor exercises alone will only cure about 50% of continence cases. Patients will often need a combination of treatments including pessaries (see below).
Pessaries: A Small Device with a Big Impact
Pessaries are soft, removable devices inserted into the vagina to support pelvic organs and reduce leakage — particularly helpful if prolapse is part of the picture.
- Non-surgical
- Can be fitted and managed in clinic and self managed by the patient
- Ideal for people wanting symptom relief to delay or avoid surgery all together
Modern pessaries are varied, discreet, and easy to use with the right support from your healthcare provider or women’s health physio.
Bladder Injectables: Yes, It’s a Thing
If urgency or urge incontinence is your main issue — and conservative measures haven’t helped —injections into the bladder wall can offer real relief.
The bladder is a muscle! Injectable muscle relaxants into the bladder reduces spasms and urgency.
Clinical studies show that bladder muscle injections can significantly reduce daily incontinence episodes for 6 to 9 months, with many patients reporting sustained improvement for up to 12 months after treatment.
It’s a procedure performed under local anaesthetic or light sedation, often as a day procedure in hospital.
It’s not for everyone — but if medications like anticholinergics or beta-3 agonists haven’t worked, it’s a proven and effective option supported by both RANZCOG and the International Urogynaecological Association.
Other Modern Tools in the Toolbox
2025 brings a suite of complementary options, including:
- Medications for overactive bladder (some now with fewer side effects)
- Neuromodulation therapies like posterior tibial nerve stimulation (PTNS)
- Lifestyle tweaks: caffeine intake, reducing bladder irritants, bladder diaries, weight management
- Surgical options: reserved for cases where conservative treatments haven’t worked — and always with informed choice
Don’t Wait to Get Help
Too many women delay treatment due to shame, embarrassment, or the belief that nothing can be done. That’s outdated thinking.
Incontinence is medical, common, and treatable! The right care starts with speaking up.
Whether you’ve just had a baby, hit perimenopause, or experienced symptoms for years, there are options that can help — and support is out there.
Final Thoughts
There is no “one right way” to manage incontinence — but you deserve a personalised, evidence-based plan to regain your quality of life.
Talk to your GP or specialist about your symptoms. You’re not being dramatic. You’re advocating for your health and wellbeing — and that matters.
References
- Cox, L., & Cameron, A. P. (2014). OnabotulinumtoxinA for the treatment of overactive bladder. Research and Reports in Urology, 6, 79–89.
- Granese, R., Candiani, M., Perino, A., Saita, A., Romano, F., & Catanzariti, F. (2014). OnabotulinumtoxinA for the treatment of overactive bladder. Research and Reports in Urology, 6, 79–89.
- American Urological Association. (2010, May 31). AUA: Long-term use of Botox may decrease urinary incontinence. MDedge: Blogs – The Hospitalist.