What is urinary incontinence (UI)?
UI is the inability to control the flow of urine. This can range anywhere from leaking a little urine when you strain, sneeze, or cough, to a total lack of control of urine. UI is not painful. If you experience pain with incontinence, notify your doctor, as this can be a sign of infection.
UI can be caused by pregnancy, childbirth, obesity, and surgery or radiation therapy for gynecologic or pelvic cancers. These events can change the nerves and muscles used to control urine flow. There are things you can do to improve your bladder health and strengthen the muscles in your pelvic floor (the muscles and supportive tissue located below the bladder).
How can I correct or prevent UI?
- Make a bathroom schedule for yourself. Urination typically occurs every 3-4 hours. Set routine times to go to the bathroom to help re-train the bladder.
- Limit your intake of caffeine, alcohol, carbonated drinks, and spicy foods. These can irritate the bladder, leading to UI.
- Make time for a “just in case” bathroom stop before leaving the house, getting in the car, or going to bed.
- Avoid drinking large amounts of fluids before going somewhere where you will not have ready access to a bathroom.
Kegel Exercises
Kegel exercises are used to strengthen the muscles of the pelvic floor, decreasing episodes of UI. A doctor, nurse, or therapist can help you make sure that you are doing the exercises correctly. The area between your hip bones is the pelvis, and this is where the pelvic floor muscles are located. To strengthen them, you want to tighten the two most important pelvic floor muscles. This can be done by tightening as if you were trying to stop the flow of urine and tightening as if you were trying to stop passing gas.
Tighten the pelvic muscles and hold for a count of 3. Then relax for a count of 3. Work up to 10 to 15 repeats each time you exercise. Do your pelvic exercises at least three times a day. Performing the exercises in three different positions (lying down, sitting, and standing) makes the muscles strongest. You can exercise while lying on the floor, sitting at a desk, or standing in the kitchen. You may not feel your bladder control improve for 3 to 6 weeks, so be patient.
Diagram of the pelvic floor muscles used for Kegel exercises.
Other Tips
- Protect your pelvic muscles by tightening them before a strain, such as sneezing, lifting, coughing.
- Biofeedback helps you become aware of your body's functioning so that you can learn to control some of those functions. This can be taught by a therapist.
- Small doses of electrical stimulation can be used to strengthen the pelvic floor muscles. Electrodes are placed in the vagina or rectum to stimulate the muscles to contract, in turn “exercising” them.
- Talk to your therapist about devices available to help with UI.
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