Bladder leakage treatment options run from simple to surgical. Lifestyle changes, bladder training and pelvic floor exercises come first, followed by pelvic floor physical therapy, devices such as a pessary and medicines for overactive bladder. Procedures and surgery are usually for leakage that has not improved enough with those steps. The right starting point depends on which type of leakage you have.
Over 25 million U.S. adults experience urinary incontinence (NAFC), and about half of U.S. women do (NIDDK). Up to 1 in 3 men over 65 do too. It is common, but it is not something you simply have to live with, and most of the options below do not involve surgery.
Below, the options run in roughly the order NIH guidance lists them, from least to most invasive, followed by where magnetic chair therapy fits.
First, Know Which Type of Leakage You Have
- Stress incontinence: leaking when a cough, sneeze, laugh or exercise puts pressure on the bladder. It is the most common type in women. Pregnancy, vaginal birth and lower estrogen at menopause can all weaken the support under the bladder, and in men it often follows prostate surgery. Read more in stress incontinence explained.
- Urgency incontinence: a sudden, strong urge to go, with leakage before you reach the toilet. It is often called overactive bladder, or OAB.
- Mixed incontinence: symptoms of both stress and urgency leakage.
- Overflow incontinence: dribbling from a bladder that does not empty properly, which always needs a doctor’s assessment.
The type matters because the first treatment differs. For stress leakage, UK guidance from NICE recommends supervised pelvic floor muscle training for at least 3 months. For urgency leakage, it recommends bladder training for at least 6 weeks. A clinician can help you work out which type, or mix, you have.
When to see a doctor
Some symptoms need a medical check before anything else. See a doctor if you notice blood in your urine, pain or burning when you urinate, a fever, sudden new symptoms, trouble emptying your bladder, or leakage that started after a new medicine.
Bladder Leakage Treatment Options Compared
The whole ladder at a glance, with how much work falls on you and how invasive each step is:
| Option | What it is | Who it suits | Your effort | Invasiveness |
|---|---|---|---|---|
| Lifestyle changes | Adjusting fluids and caffeine, managing weight, avoiding constipation | Anyone with leakage, as a base | Low to moderate | None |
| Bladder training | A bathroom schedule that slowly lengthens the time between trips | Urgency leakage | Moderate | None |
| Supervised pelvic floor muscle training | Daily pelvic floor exercises, checked by a trained clinician | Stress leakage | High, daily practice | None |
| Pelvic floor physical therapy and biofeedback | One-on-one sessions to check technique and build a program | People unsure they are doing exercises correctly | Moderate to high | Low; any internal exam needs your consent |
| Pessary | A small removable device that supports the bladder | Women who want support without surgery | Low | Low |
| Medicines for overactive bladder | Prescription medicines; for some, injections into the bladder muscle or nerve stimulation | Urgency leakage not settled by bladder training | Low | None to minor procedure |
| Vaginal estrogen | Low-dose estrogen prescribed by a doctor | Menopause-related bladder symptoms | Low | Low |
| Bulking injections | Material injected near the urethra to help it close | Stress leakage after other steps | Low | Minor procedure |
| Sling or artificial sphincter surgery | A sling to support the urethra, or (for men) an artificial urinary sphincter | Stress leakage that persists | Surgery and recovery | Surgical |
| Magnetic chair therapy | Sitting fully clothed on a chair that causes involuntary pelvic floor contractions | When exercises have not helped enough or are hard to do | 24 visits over 8 weeks | None; nothing is inserted |
Start Here: Lifestyle, Bladder Training and Pelvic Floor Exercises
These low-risk steps are where the guidelines begin.
Lifestyle changes
Small habits form the base of every plan: paying attention to how much and when you drink, cutting back on caffeine, working toward a healthy weight, and avoiding constipation. They are the first step in the NIH’s treatment overview.
Bladder training
Bladder training means going to the bathroom on a schedule and slowly stretching the time between trips, rather than going at every urge. For urgency leakage, NICE recommends it as the first treatment, for at least 6 weeks. A clinician can help you set a realistic schedule.
Supervised pelvic floor muscle training
Pelvic floor muscle training, often called Kegels, is the first-line treatment for stress leakage. NICE recommends a supervised program of at least 8 contractions, 3 times a day, for at least 3 months. The word “supervised” matters. In one study, only 49% of women did an ideal Kegel after brief verbal instruction, and 25% used a technique that could promote incontinence (Bump, 1991). If you have been squeezing faithfully without much change, read why Kegels may not be working and what to try next.
After having a baby, the Office on Women’s Health advises seeing a provider if leakage lasts beyond 6 weeks. See bladder leaks after having a baby for what is normal and what helps.
Next Steps: Physical Therapy, Devices, Medicines and Surgery
If the first steps have not helped enough, these are the next options.
Pelvic floor physical therapy and biofeedback
A pelvic floor physical therapist can check whether you are using the right muscles and build a program around you. Some programs use biofeedback, which shows you whether you are contracting the right muscles. For women who cannot actively contract the pelvic floor, NICE suggests considering electrical stimulation or biofeedback. An assessment may include an internal exam, but only with your consent, and physical therapy is often covered by insurance with a referral. For a side-by-side look, see pelvic floor chair therapy vs pelvic floor physical therapy.
Pessary
A pessary is a small, removable device, fitted by a clinician, that sits in the vagina and helps support the bladder. Your gynecologist can tell you whether it suits you.
Medicines and other treatments for overactive bladder
For urgency leakage that bladder training has not settled, NICE’s next step is to add a medicine for overactive bladder. The NIH lists anticholinergic and beta-3 agonist medicines and, for people who need more, injections into the bladder muscle given by a urologist, and nerve stimulation treatments. A doctor prescribes and monitors all of these.
Vaginal estrogen for menopause-related symptoms
Falling estrogen around menopause can bring urgency, frequency, waking at night to urinate, leakage and repeat urinary tract infections. The American Urological Association’s 2025 guideline on these symptoms recommends offering low-dose vaginal estrogen. A doctor prescribes it and can tell you whether it suits you.
Procedures and surgery
When stress leakage persists despite other treatment, a urologist or urogynecologist may suggest a procedure. Bulking injections place material near the urethra to help it close. Sling surgery places a supportive strip under the urethra. As the most invasive steps, they usually come last.
For men after prostate surgery
Leakage after prostate surgery is expected at first. The American Urological Association’s guideline says it generally improves to near baseline by 12 months, and that pelvic floor muscle training should be offered right after surgery. If leakage is not improving, surgery may be offered at 6 months and should be offered at 1 year. The main options are the artificial urinary sphincter and the male sling. Read more in pelvic floor therapy for men after prostate surgery.
Where Pelvic Floor Chair Therapy Fits
Magnetic pelvic floor chair therapy sits outside the standard treatment ladders. It does not appear in the NIH’s overview or in NICE guidance, and some insurers, including Aetna, classify magnetic pelvic floor stimulation as experimental. It is an option people consider when exercises have not helped enough or are hard to do correctly, alongside medical care rather than instead of it.
The research is small and limited. A 2021 meta-analysis of six small sham-controlled trials found magnetic stimulation reduced stress leakage in women compared with a placebo treatment, although the authors flagged study-quality problems. A 2025 systematic review of five small studies (about 219 women) found chair-based magnetic stimulation was associated with less leakage, but rated that evidence low certainty. None of these studies used the Pelvic Wave chair; they tested other magnetic chairs.
You sit fully clothed on a chair whose seat produces an electromagnetic field that reaches up to 4 inches deep. The field causes involuntary pelvic floor muscle contractions: more than 5,600 in a 20 minute session, according to the manufacturer. Because the contractions are involuntary, they do not depend on you finding the right muscle yourself. There are no probes, wires or electrodes, nothing is inserted, and there is no internal exam. A typical program is 24 sessions over 8 weeks, with maintenance of 3 sessions every 6 months.
According to the manufacturer, the chair relies on a 1998 clearance (510(k) K973096) for technology that is FDA-cleared for the treatment of urinary incontinence in women. That clearance covers women, not men, so men talk through whether it suits them at the free consultation and keep their urologist informed. Chair therapy is not suitable for anyone who is pregnant or may be pregnant, has an implanted pacemaker or defibrillator, or has a history of cardiac arrhythmia or atrial fibrillation. Anyone with metal or electronic implants should raise them at the consultation.
Pelvic floor chair therapy at Elume is provided by Restore Innovations, an independent practice located within Elume Medspa. You can read more about pelvic floor therapy in Fairfax, VA, or see what to expect from pelvic floor chair therapy.
Frequently Asked Questions
How can I stop leaking urine without surgery?
Most plans start without surgery: lifestyle changes, bladder training, pelvic floor exercises, physical therapy, a pessary, medicines for overactive bladder and, around menopause, vaginal estrogen prescribed by a doctor. Some people also consider magnetic chair therapy. Surgery is usually kept for leakage that has not improved enough with these steps.
Does the pelvic floor chair really work?
The evidence is limited. Small studies of other magnetic chairs found less leakage, but reviewers rated the evidence low certainty, and none of the studies used the Pelvic Wave chair. People usually consider it when exercises have not helped enough, and no one can promise results.
Will insurance cover bladder leakage treatment?
Pelvic floor physical therapy is often covered with a referral, so check with your plan. Magnetic chair therapy is different: some insurers, including Aetna, classify magnetic pelvic floor stimulation as experimental, so it is usually self-pay. Restore Innovations explains the full cost of any recommended plan before the first session.
Is bladder leakage a normal part of getting older?
It is common with age, but you do not have to accept it. The Office on Women’s Health reports that over 40% of women 65 and older have urinary incontinence, and the NIH says up to 1 in 3 men over 65 do. It is worth raising with a clinician at any age.
Talk It Through With Restore Innovations
If you have tried exercises and wonder whether pelvic floor chair therapy could fit your plan, Restore Innovations can talk it through with you. You can book a free 15 minute phone consultation, where Restore Innovations calls you, or choose a free 30 minute consultation in person at the suite inside Elume Medspa, 3925 Blenheim Blvd, Suite 53-D, Fairfax. You can also call Restore Innovations at (571) 299-8780. Consultations are by appointment only, and the full cost of any recommended plan is explained before the first session.
Sources
- Bladder Control Problems and Bladder Leakage, NIDDK (accessed 2026)
- What to Know About Urinary Incontinence in Women, National Association For Continence (accessed 2026)
- Urinary Incontinence, Office on Women’s Health (accessed 2026)
- Urinary incontinence and pelvic organ prolapse in women: management (NG123), NICE (2019)
- Incontinence after Prostate Treatment guideline, American Urological Association (2019, amended 2024)
- Clinical Policy Bulletin 0223, Aetna (accessed 2026)
- Efficacy of magnetic stimulation for female stress urinary incontinence: a meta-analysis, Therapeutic Advances in Urology (2021)
- Systematic review of chair-based magnetic pelvic floor stimulation in women with urinary incontinence (Sacarin et al.), Journal of Clinical Medicine (2025)