Learn how you can take control of your bladder, instead of letting it control you.
Urinary incontinence is definitely one of the most embarrassing health problems that many patients suffer from, but are afraid to ask about. It’s up there with anal itching, hirsutism, dandruff, and nipple discharge, all previous topics I’ve covered on Quick and Dirty Tips. It is so common that it is likely underestimated – research shows that 1 in 4 women over the age of 18 suffer from it. It is also thought that men suffer nearly as much as women do, but they are less likely to seek their doctor’s help or talk about it.
It always makes me so sad to hear a patient tell me that they’ve been hiding their incontinence issues for years before they finally admit to it. Because we are doctors, we know how common it is, we see it every day…so let us help. Tell us.
We know it can be an uncomfortable topic to talk about, so that’s why today I’d like to discuss techniques that you can actually do at home on your own to help retrain your bladder and alleviate your symptoms.
What Is Incontinence?
Urinary incontinence is simply the involuntary leakage of urine. Some patients may leak urine on their way to the bathroom – this is called “urgency incontinence.” And some patients may leak with coughing, sneezing, and laughing, and this is termed “stress incontinence.” The truth is, most people have what’s called “mixed incontinence,” and they suffer from a mix of both forms.
You can read more about urinary incontinence here.
What Can You Do to Retrain Your Bladder?
1. Discuss it with your doctor. Bladder problems can be triggered by certain medications, like diuretics for high blood pressure. It can also be caused by certain health conditions like diabetes. Review this with your doctor to make sure that something as simple a changing your medication can’t make a big difference.
2. Examine Your Diet. Caffeine, chocolate, alcohol, citrus, tomatoes, and artificial sweeteners are bladder irritants. Before you start your retraining marathon, make sure to eliminate them from your diet.
3. Start a Bladder Diary: Start keeping a log of the date, time, type of drink and amount consumed, amount of voided urine (which can be measured with a hat-like device you can purchase and place over the toilet rim), and whether your accidental leak was a small, medium, or large one. Also, note whether you felt the urge to go during the leak, and what you were doing when you leaked (like coughing, running to the bathroom, etc). Here’s an example of a bladder diary you can print from the internet.
4. Urge Suppression: Retrain your bladder to retain more and more fluid with time and according to your schedule, not your bladder’s. When you feel the urge to go:
Sit down somewhere comfortable
Don’t walk or run
Concentrate on slowly tightening and relaxing the pelvic muscles until your urge is gone
Take deep breaths, in and out, and focus on relaxing your abdominal muscles
5. Schedule Bathroom Breaks: Review your diary, and select a comfortable interval to schedule your bathroom breaks during the daytime hours (not during sleep). Then, use the bathroom even if you don’t have the urge to go. If you feel the urge earlier, then practice the previously mentioned step 4. At first, it’s normal to feel some possible leakage. But this will improve after several days. Then you can increase your interval by 15 minutes. Your ultimate goal will be to increase your interval to three hours. It may take 6 to 8 weeks to reach your goal.
6. Practice Your Kegels: Contrary to popular belief, women aren’t the only ones who can benefit from Kegel exercises. This is essentially physical therapy for your pelvic muscles, the ones that hold your bladder to the pelvis. The easiest way to isolate these muscles is to stop the flow of urine the next time you’re using the bathroom. Feel that tightening? That’s the pelvic floor working. Here are 4 exercises to practice twice a day:
Tighten your pelvic floor, hold for 3 seconds, and relax them slowly over the next 3 seconds. Repeat this 10 times. Then gradually increase the hold to 10 seconds and relax over 10 seconds.
Tighten the same muscles, but this time swiftly, and relax them swiftly. Repeat 10 times.
Tighten the same muscles while coughing, then relax. Then repeat 10 times. You may leak initially, and this is OK.
Tighten the same muscles while standing up, and then relax. Then tighten while slowly sitting down, and relax. Repeat 10 times.
It may take up to two weeks to see a difference, and 2-3 months to notice a big change. But it will be worth the effort.
If you still have incontinence despite the above measures, discuss the following possibilities with your doctor:
A pessary device
Whatever you do, don’t be reluctant to discuss it with your doctor. Believe me, they’ve heard it a thousand times before.
Do you ever hesitate to talk to your doctor about your personal health issues? Tell us why you hesitate on the House Call Doctor’s Facebook and Twitter pages! If you have any suggestions for future topics you can email me at firstname.lastname@example.org.
Please note that all content here is strictly for informational purposes only. This content does not substitute any medical advice, and does not replace any medical judgment or reasoning by your own personal health provider. Please always seek a licensed physician in your area regarding all health related questions and issues.