Tips for Dealing with Urinary Incontinence (For Women)

What is urinary incontinence (UI)?

Urinary incontinence (UI) is when you cannot control the flow of your urine. UI can mean leaking urine when you strain, sneeze, or cough, or a total lack of urine control. UI is more common in females than in males due to a female’s urethra being shorter. UI is not painful. If you have pain with incontinence, talk to your provider, as this can be a sign of infection.

UI can be caused by pregnancy, childbirth, older age, diabetes, smoking, and obesity. It can also be caused by cancer, which can damage or weaken the nerves and muscles used to control urine flow. And, it can be caused by cancer treatments such as surgery, certain medications or radiation therapy for gynecologic or pelvic cancers. The main types of UI that may happen after cancer or cancer treatment are:

• Urgency incontinence: When you feel the urge to urinate but cannot make it to the toilet in time. This is often due to bladder spasms.
• Stress urinary incontinence (SUI): Urine leaks when there is pressure put on your bladder. This often happens with exertion (movement) or effort. This can happen when you cough, sneeze, lift something heavy, change position, swing a golf club, or exercise.
• Overflow incontinence: When you are unable to empty the bladder completely, which can cause incontinence when the bladder overflows.
• Continuous Incontinence: A complete lack of control of urine flow.

Urgency and stress incontinence are most common in females. You may have one or more types of UI (also called mixed incontinence). UI can be a problem that happens right after treatment, or it can happen years after therapy.

What can I do about UI?

There are things you can do to improve your bladder health and to make your pelvic floor muscles (the muscles below your bladder) stronger.

• Make a bathroom schedule for yourself. Most people need to urinate about every 3 to 4 hours. Set times to go to the bathroom to help retrain your bladder.
• Make time just in case you have to stop at the bathroom before leaving the house, getting in the car, or going to bed.
• Limit how much caffeine, alcohol, carbonated drinks, and spicy foods you have. These can irritate your bladder.
• You may not want to drink large amounts of fluids before going somewhere if you will not have access to a bathroom. But it is important to avoid dehydration. Talk to your provider before decreasing the amount of fluid you drink.
• You can do Kegel exercises to make your pelvic floor muscles stronger and lower the risk of UI. During this exercise, you will feel a pulling in your rectum and vagina. This can be done by:
  • Tightening as if you were trying to stop the flow of urine and as if you were trying to stop passing gas. Start with an empty bladder. Tighten the pelvic muscles and hold for a count of 5. Then relax for a count of 5. Do this 10 times, 3 times per day. Doing the exercises in three different positions (lying down, sitting, and standing) makes the muscles strongest.
  • You can do this exercise anywhere, only you will know you’re doing it. You may not feel your bladder control improve for 3 to 6 weeks, so be patient.
• Protect your pelvic muscles by tightening them before a strain, such as sneezing, lifting, coughing.
• Biofeedback (a mind-body technique used to help control different body functions) helps you become aware of your body so that you can learn to control some of those functions. This can be taught by a physical therapist. Talk with your care team about working with a physical therapist.
• Small doses of electrical stimulation can strengthen your pelvic floor muscles. Electrodes are placed in your vagina or rectum to stimulate the muscles to contract, in turn "exercising" them.
• Talk to your physical therapist about devices you may be able to use to help with UI.

When should I call my care team?

If you are having urinary incontinence or pain/burning with urination, talk with your care provider.