Medical News Today: Coping with urinary incontinence

Urinary incontinence is a common and sometimes embarrassing condition. So, we have put together some strategies that should improve your symptoms and help you cope with the day-to-day challenges of urinary incontinence.
woman holding her crotch
Steps can be taken to alleviate symptoms of urinary incontinence.

Urinary incontinence affects millions of men and women of all ages.

It is estimated to occur in around 2–3 percent of teenagers. Teenagers with incontinence are at an increased risk of underachieving at high school.

Almost 25 percent of women experience urinary stress incontinence for at least 1 year following childbirth.

Many women report that a weak bladder deters them from participating in sports, or prompts them to give up altogether.

Urinary incontinence also affects 11–34 percent of older men, according to the National Institute of Diabetes and Digestive and Kidney Diseases.

Urinary incontinence, or the loss of bladder control that results in urine leakage, is a widespread problem. But some steps can be taken to reduce your symptoms.

Medical News Today detail the best strategies to strengthen your pelvic floor muscles and retrain your bladder, as well as lifestyle changes that you can make to ensure your symptoms of urinary incontinence are a thing of the past.

1. Perform pelvic floor exercises

Your pelvic floor is a sheet of muscles that supports your bladder and bowel. If it weakens, you may experience urine leakage when coughing, laughing, or sneezing, a need to go to the bathroom frequently, or an urgency to get to the bathroom and leaking on the way.

older woman sitting at a desk
Pelvic floor exercises can be practiced anywhere — at home, while walking, and even at your desk.

Pelvic floor exercises, which are sometimes known as Kegel exercises, aim to strengthen your muscles to support your organs, improve bladder control, and prevent urine leakage.

The University of Otago in New Zealand led a review of studies that compared the exercises with no treatment. They found that people who practiced Kegels were 2.5–17 times more likely to fully recover from urinary incontinence.

Another study — by the Université de Montréal in Canada — discovered that adding dance to a pelvic floor muscle program was a recipe for success.

Practicing the combined program on a video game console led to a decrease in daily urine leakage in women over the age of 65 years, compared with the pelvic muscle floor program alone.

The team revealed that the fun dance element motivated women to show up to the physiotherapy program each week, which improved their practice frequency and therefore strengthened their pelvic floor muscles further.

Dancing also allowed the women to apply pelvic floor muscle exercises — which are traditionally performed while static — to movement.

After menopause, physical therapy involving pelvic floor muscle exercises has also been found to dramatically reduced urine leaks by 75 percent in women with urinary incontinence and osteoporosis.

How to do pelvic floor exercises

First, you need to locate your pelvic floor muscles, which you can do by trying to stop your flow of urine mid-stream. Exercises should be performed at first by sitting on a chair with your feet flat on the floor, and your elbows rested on your knees.

Two types of exercises, called slow contraction and fast contraction, should be performed to give your pelvic floor a full workout. Always do the slow contraction exercises first and then the fast contraction exercises.

To practice slow contraction exercises:

  • Draw up your muscles surrounding your anus as if you are trying to stop yourself passing gas. However, do not squeeze your buttock muscles.
  • Also, draw up the muscles around your urethra as if you are trying to stop urine flow.
  • Hold this position for as long as you can. You may only be able to hold this contraction for a couple of seconds at first, but the goal is to hold for a count of 10 seconds.
  • Slowly relax and let go for 10 seconds.
  • Gradually increase the time you hold the contraction and repeat until your muscles begin to feel tired.

To practice fast contraction exercises:

  • Draw up the muscles surrounding your anus and urethra as before.
  • Hold the contraction for 1 second and then let go and relax.
  • Repeat the contractions up to 10 times or until your muscles tire.

Try to come up with an exercise plan that includes 10 slow contractions and three sets of 10 fast contractions twice per day.

Make sure that you breathe normally while exercising and are focusing on the correct muscles. You should begin to see results within 3–6 months.

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2. Retrain your bladder

The American College of Physicians clinical practice guidelines for the nonsurgical management of urinary incontinence suggest bladder training for women with urinary incontinence and pelvic floor muscle exercises with bladder training for mixed urinary incontinence.

person sitting cross legged with their phone
Distraction and delay techniques such as sitting cross-legged, clenching your fists, or simply thinking about something else can delay your trip to the bathroom.

Bladder training is a behavioral therapy that aims to increase the time between urinating.

Muscles control the bladder, which means that the muscles can be strengthened a similar way to working out your biceps and quadriceps.

Individuals with urinary incontinence normally develop a habit of going to the bathroom too often to ensure that they are not caught out.

However, this sort of behavior exacerbates the problem by causing the bladder to get used to holding less urine and making it more sensitive and overactive.

Bladder training can help to reduce urinary incontinence by helping the bladder to hold more urine and prevent it from being overactive.

It can be useful to keep a diary of information linked to your condition before you start training so that you have a starting point from which you can measure progress.

In your bladder diary, record the times that you urinate, whether or not you could completely empty your bladder, the duration between trips to the bathroom, and any other relevant information.

Schedule bathroom visits. The goal of bladder training is to decrease the times that you urinate each day to around six to eight times.

Look at when you recorded going to the bathroom in your bladder diary and gradually extend the duration between bathroom visits. For example, if you go to the bathroom once per hour, aim to extend that to 1 hour and 15 minutes and increase that time gradually over the few next weeks.

Delay urination. If you feel the urge to go to the bathroom, try to delay your trip by around 5 minutes. Slowly continue to delay urinating until you can get to around 3–4 hours between bathroom visits.

The following tips may help you to increase your success with bladder training:

  • Do not rush to the bathroom when you feel the urge to urinate. Sit still and try to hold on as long as possible.
  • Avoid unhealthful habits of going to the bathroom “just in case.”
  • Distract your attention by thinking about something else.
  • Try delaying tactics such as clenching your fists or crossing your legs.
  • Practice pelvic floor exercises to strengthen your power to hold urine.
  • Continue to drink plenty of water each day to ensure you do not develop a urinary tract infection.
  • Limit drinks that increase urination, such as coffee, tea, and other caffeinated beverages.

Your physician will advise a program that is right for you, but most bladder training includes similar techniques.

3. Maintain a healthy BMI

Being overweight or obese is associated with a higher risk of developing urinary incontinence. In fact, one study of women over the age of 70 revealed that prevalence of urinary incontinence and stress urinary incontinence was no less than twofold higher among those in the highest body mass index (BMI) category than the lowest.

couple buying vegetables
Try including more fruits and vegetables in your diet to help you maintain a healthy BMI.

Furthermore, women who took action to lose at least 5 percent of their BMI had a lower chance of experiencing new or persistent stress urinary incontinence over 3 years than those who lost less weight.

Aiming to reduce your BMI if you are overweight or obese could help you to get your urinary incontinence under control.

You can decrease your BMI by following healthful lifestyle choices, such as:

  • brisk walking for 30 minutes on 5 days of the week
  • reducing the number of calories you consume for how active you are
  • consuming a diet rich in fruits and vegetables
  • filling half of your plate with vegetables at meal times
  • replacing refined grains with whole grains
  • increasing fiber intake
  • avoiding sugary snacks
  • cutting down on saturated fats
  • ditching processed foods

A dietitian can create an eating plan that is both healthful and balanced to ensure that you are getting all the nutrients that your body needs.

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4. Limit alcohol and caffeine

Alcohol and caffeinated beverages increase urine production. Therefore, it is advisable to limit the consumption of these if you have urinary incontinence.

several cups of coffee
Limit consumption of alcohol and caffeine, as these increase urine production.

One study published in The Journal of Urology unearthed a link between drinking coffee and urinary incontinence in men.

The researchers found that coffee consumption that is equivalent to drinking two cups of coffee per day is significantly associated with male urinary incontinence.

Specifically, their analysis revealed that men who consumed more than 234 milligrams of caffeine daily were 72 percent more likely to have moderate to severe urinary incontinence than those who consumed none at all.

Another study showed that an intake of at least 204 milligrams of caffeine per day was associated with urinary incontinence in women.

5. Practice yoga

Trying out the ancient art of yoga may go some way to reducing symptoms of urinary incontinence, according to the University of California, San Francisco (UCSF).

woman doing bridge yoga pose
Practicing yoga may help to reduce some of the symptoms of urinary incontinence.

UCSF found that yoga could help people with urinary incontinence gain more control over urination and avoid accidental leakage.

Individuals who took part in a yoga program that was designed to improve pelvic health had a 70 percent reduction in their urine leakage.

The researchers indicated that yoga could improve urinary incontinence for multiple reasons.

Incontinence is often connected with anxiety and depression, so people living with incontinence may benefit from the mindful meditation and relaxation side of yoga.

Regularly practicing yoga might also help to strengthen pelvic floor muscles that support the bladder and safeguard from incontinence.

The Yoga Journal recommends the following Viniyoga sequence to help create pelvic stability:

  1. Hook Lying with a block
  2. Reclining Bound Angle Pose
  3. Two-Footed Pose
  4. Reclining Wide-Legged Hand-to-Big-Toe Pose
  5. Legs-up-the-Wall Pose

A systematic review of all papers written about urinary incontinence in 2005–2015 discovered that surgery outranks all other methods of treating incontinence. Surgery was successful in 82 percent of cases compared with 53 percent for pelvic floor exercises and 49 percent for drug treatment.

If you are worried about urinary incontinence, contact your doctor and discuss any lifestyle changes and treatment options that might be available.

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