Treatment of Urinary Incontinence

Evaluate your Medications

Talk to you doctor about any prescriptions, over the counter medications, or herbal supplements that you are taking. These can cause or aggravate the symptoms of your incontinence. Here are some common medications that might be contributing to your incontinence:

• Alpha adrenergic blockers such as Terazosin (Hytrin) prescribed for men with enlarged prostate can cause too much relaxation of the bladder muscles leading to incontinence.
• Pseudoephedrine, which is found in many over the counter decongestants, may cause overflow incontinence.
• Beta-adrenergic blockers are medications prescribed for high blood pressure and/or chest pain. These can relax the sphincter in the bladder and cause stress incontinence or constant dribbling of urine.
• Diuretics, which are used to remove excess fluid from the body, can also aggravate incontinence.

Modify Your Diet

Many people with incontinence tend to avoid drinking fluids, since it causes them to have to frequently use the bathroom. Not drinking enough fluid can actually cause incontinence to get worse. Your body needs fluids, most importantly water. Water is a bladder friendly substance - it flushes out irritants that can accumulate in the bladder. Drinking water, several 8 ounce glasses per day, is an important part in getting your bladder healthy again.

Stop drinking fluids in the early evening to prevent incontinence at night. Include fiber in your diet by eating fruits, vegetables, whole grains and beans. A healthy diet rich in fiber, keeps your digestive system regular and reduces constipation. Constipation can put extra pressure near the pelvic floor and can aggravate incontinence.

Avoid or consume the following foods and beverages in moderation (no more than 1-2 servings per day)

• Caffeine, tea, alcoholic beverages, and carbonated beverages (soda)
• Spicy foods, citrus foods and drinks (orange juice, grapefruit)
• Tomato based foods (spaghetti sauce)
• Chocolate

Maintain a Healthy Weight

If you are overweight, weight loss can help improve your urinary incontinence symptoms. Studies show that people who have extra weight may have a higher risk of incontinence. Extra weight can put pressure on the bladder muscles and nerves, causing urine to leak out unexpectedly.

Kegel Exercises

General aerobic exercise is beneficial for almost everyone, but specific exercises geared to the bladder are very important if you have incontinence. Strengthening your pelvic floor muscles help supports the bladder and prevents leakage. Kegel exercises are a common treatment for both men and women with stress incontinence. Pregnant women are also instructed to perform Kegel exercises to strengthen and prepare the pelvic floor muscles for childbirth. It is important to do the exercises properly, several times per day to get the best results.

To figure out how to correctly perform Kegel exercises, you can try to stop the flow of urine while voiding. The squeeze you perform is from your pelvic floor muscles. It is important not to do this frequently as a type of exercise. This is only a way to identify if you are correctly contracting your pelvic floor muscles. Continuing to do this as exercise during urination, can cause bladder irritation, urinary tract infections, and send mixed messages to the urinary system. Another way to identify the pelvic floor muscles is to pretend you are preventing yourself from passing gas. Your pelvic floor are the muscles responsible from preventing the passage of gas.

Once you have identified your pelvic floor, try to imagine that those muscles are like an elevator. Start to squeeze gently, and gradually pull tighter as the elevator rises up in the pelvis (up toward your belly button). Hold this position for 3 seconds. Relax and repeat this exercise 10 times, 3-5 times per day. As you get better at this, try to hold the contraction for longer than 3 seconds. Work up to holding this exercise for a full count of 10. When you are doing your Kegel exercises, make sure to remember to breathe. If you hold your breath, it prevents your pelvic floor from contracting efficiently. Do not contract your abdiminals or your buttock muscles while performing Kegel exercises. This will enable you to get the best results out of your exercise sessions.

Quit Smoking

If you smoke, stop. Not smoking will reduce how much you cough, which will provide less strain on the bladder if you have stress incontinence.

Keep a Bathroom Schedule

It is helpful to record how often and how much urine your body puts out each day. If you frequently go to the bathroom to prevent an accident, it reinforces to your bladder that it has to empty frequently - even when it is not full. Your bladder gets used to wanting to empty very frequently. Work up to a schedule of every 3-4 hours between bathroom trips. If you feel the need to urinate, sit down and cross your legs. Stay still and calm. This may help decrease the feeling of urgency. Getting on a more regular bathroom schedule of every 3-4 hours will retrain the signal between the bladder and brain. Many times you might feel the urgency to go, but pass very little urine. The signal between the bladder and brain is confused, and working up to 3-4 hours between bathroom trips can help the bladder from sending a mixed signal about the need to urinate. Voiding Diary Example

Electrical Stimulation

This treatment uses a mild electrical current to activate the pelvic floor or relax the muscles that support the bladder. This is usually performed by a physician and/or physical therapist that specializes in urinary incontinence. This may be indicated for the treatment of urge incontinence.

Acupuncture

Studies show that this type of treatment might be beneficial for those with urge incontinence. Talk to your doctor to see if this is an option for you.

Urethral bulking

Collagen injections around the urethra (the tube that carries urine out of the body)can help provide resistance to reduce urinary leakage. This is not indicated for everyone. Talk to your doctor to see if this is an option to help reduce the symptoms of your urinary incontinence. Talk to your doctor to see if this type of treatment would help your type of incontinence.

Surgery

There are many different types of surgeries to correct urinary incontinence. Surgery should be considered only if conservative measures fail. Surgery is generally indicated for more severe cases of urinary incontinence. It is difficult to choose which type of surgical procedure might be right for you since there are over 200 types of different procedures. Make sure to discuss all your options with your doctor.

Other Helpful Hints

Wearing a tampon while running or doing strenuous exercises can help provide resistance to the urethra to slow down urine leakage associated with stress incontinence. This should not be done on a daily basis or all day long. This is only helpful when performing strenuous activities for a short duration of time.

Incontinence Alarms

There is some evidence that use of incontinence alarms for night time use can be helpful in training children with chronic bed wetting issues.