From the Research
Incontinence following urethral dilation is relatively uncommon, occurring in approximately 1-5% of patients. Most cases of post-procedural incontinence are temporary and resolve within a few days to weeks as the urethral tissues heal. The risk increases in elderly patients, those with pre-existing pelvic floor weakness, neurological conditions affecting bladder control, or when excessive force is used during the procedure. Urethral dilation works by stretching the urethra to relieve narrowing (strictures), but this stretching can temporarily affect the normal functioning of the urethral sphincter, which controls urine flow.
- Patients should be advised that mild stress incontinence (leakage with coughing, sneezing, or physical activity) may occur initially after the procedure.
- Management typically involves pelvic floor exercises, timed voiding, and in some cases, temporary use of incontinence products.
- If incontinence persists beyond 2-3 weeks, patients should follow up with their urologist as this may indicate more significant sphincter damage or other complications requiring additional evaluation and treatment. The most recent and highest quality study on the topic of urinary incontinence treatment, including the effects of urethral dilation, is from 2021 1, which evaluated the effect of a combination of innovative pelvic floor muscle training and duloxetine compared with the use of duloxetine alone on women with stress urinary incontinence. However, this study does not directly address the frequency of incontinence following urethral dilation.
- Another relevant study from 2018 2 found that pelvic floor muscle training can cure or improve symptoms of stress urinary incontinence and other types of urinary incontinence, and may reduce the number of leakage episodes and the quantity of leakage on short pad tests in the clinic.
- It is essential to consider the individual patient's risk factors and medical history when assessing the likelihood of incontinence following urethral dilation, as the risk can vary significantly from one patient to another. The evidence from these studies 1, 2 suggests that while incontinence following urethral dilation is a potential complication, it is relatively rare and often temporary, and that pelvic floor muscle training can be an effective treatment for urinary incontinence.