Urinary Incontinence

Self-management

Self-management

There are many different ways of coping with urinary incontinence. Seek help if your symptoms bother you: consult your family doctor, general practitioner, or a urologist. It may be uncomfortable to discuss your condition with a doctor, but it is the most effective way to deal with your concerns.

There is no single solution to incontinence that works for everyone. Self-management measures can significantly improve your condition and lead to a better quality of life. These measures include lifestyle changes, bladder training and pelvic floor muscle exercises. Other treatment options, such as surgery and medication, should be considered if self-management is not effective.

Discuss with your doctor, consultant or specialist nurse which measures can help you can take control of the condition. It is common to try different options to figure out which one works best for you.

Lifestyle advice

Your diet can have an effect on urinary incontinence. By looking at when, what, and how much you drink or eat, you may find behaviours which worsen your condition. Minor changes to your dietary habits can offer some improvement.

Drinking too much or too little throughout the day will affect your incontinence. You should discuss with your doctor how much you should drink in a day. It may seem like an easy solution to drink less  to avoid urine leakage. However, this can be harmful because it may lead to  dehydration, urinary tract infections, urinary stones, or constipation.

Caffeine, alcohol, and soft drinks do not cause incontinence but it is well known that they can worsen urgency and frequency symptoms in some people. Avoiding these types of drinks may improve your condition. Remember that even drinks marked as decaffeinated may have some caffeine.

Certain types of food could irritate the bladder. The most common are spiced or spicy food and sharp-tasting food, like lemons or strong cheeses. It may help you to avoid food that you think makes the incontinence worse. The best way to figure out what works for you is to try different things.

Constipation and obesity have been linked to incontinence. To have a healthy weight and maintain regular bowel movements, it is important that you have a balanced and varied diet which includes vegetables, fibre, and fruits. Some of your symptoms may improve if you lose weight.

Bladder training

Your doctor may recommend a course of bladder training. The first step of the training is to keep a bladder diary. Here you record how much you drink, how often you urinate, and how much urine you produce. Based on this information your doctor will propose a schedule for urinating. By following the schedule you train your bladder. If training is successful, the bladder can also hold more urine.

Pelvic floor muscle exercises

The pelvic floor muscles support the bladder and the bowel (Fig 1a and 1b). They can weaken with age, illness, or hormonal changes. Pregnancy and childbirth can weaken the pelvic floor muscles in women. Weak pelvic floor muscles can lead to urine leakage.  Prostate surgery, and in particular radical prostatectomy, can weaken the pelvic floor muscles in men.

A structured programme of exercises to strengthen the pelvic floor muscles can improve urinary incontinence. It consists of a series of exercises to train the muscles, which is designed specifically for your needs.

Always consult your health care professional before trying these exercises.

pelvic floor muscles
Fig. 1a: Pelvic floor muscles in men.
pelvic floor muscles
Fig. 1b: Pelvic floor muscles in women

General instructions for pelvic floor muscle exercises

This is a general pelvic floor muscle exercise programme. Discuss with your doctor the schedule for your individual programme. Always practice the exercises with an empty bladder.

The first exercise is aimed at the front pelvic floor.

  • Find a position that is comfortable for you, this could be laying down, sitting, or standing.
  • Squeeze and pull up your pelvic floor muscles as though you are trying to stop the flow of urine, and relax immediately. Repeat this fast exercise up to 10 times.
  • Next, do the same exercise again but this time try to hold on for up to 5 seconds before relaxing. Repeat this slower exercise up to 10 times. It may take a few weeks for you to manage to hold for 5 second before relaxing. Your muscles have to build up strength.

The next exercise is aimed at your rear pelvic floor.

  • Squeeze and pull up the muscles as though you are trying to stop the flow from your rectum, and relax. Repeat this exercise up to 10 times.
  • Perform the same exercise again but this time try to hold the squeeze and pull sensation for up to 5 seconds before relaxing. Repeat up to 10 times.

These exercises work best if they are repeated every day. It takes at least 3 months for the muscles to gain strength and tone.

Remember that you are training muscles and over-exercising can harm them. Do not try to do more than 10 repetitions of each exercise in one attempt and do not do more than 3 cycles of exercises in a day. Your specialist nurse or urologist will give you a personalised schedule.

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