Intro

If you have a problem with urine leakage or have to get up more than twice in the night to urinate, make an appointment with your health care provider. The problem may be caused by a medical condition that can be treated. You owe it to yourself to find out. Most likely you do not have to resign yourself to living with incontinence for the rest of your life.

If you have kept records of urination ("urination diary"), take a copy with you to the appointment. Be prepared to provide a complete list of your medications, including nonprescription drugs, herbs, and supplements.

Self-Care at Home

Incontinence is never normal. If you have a problem with urine leakage, you should see a medical professional.

While waiting for your appointment, make yourself more comfortable.

• Avoid foods and drinks that may irritate the bladder. These include alcohol, caffeine, carbonated drinks, chocolate, citrus fruits, and acidic fruits and juices.
• Do not drink too much fluid. Six to 8 cups a day is adequate, more if you are exercising, sweating a lot, or the weather is hot. In people with kidney stone disease, voiding at least 2 liters of fluid per day is important. Fluid restriction may lead to stone growth or formation.
• Urinate regularly.
• Do not ignore the urge to urinate or to have a bowel movement.
• If you are overweight, try to get to a healthier weight.
• If necessary, wear absorbent pads to catch urine.
• Maintain proper hygiene. This will help you feel more confident and will prevent odors and skin irritation.

Kegel exercises: Exercising the muscles of your pelvic floor may benefit women with either stress or urge incontinence.

• The exercises involve strongly contracting the pelvic muscles that you use to hold back urine.
• Many women are familiar with these exercises from childbirth classes.
• To find the muscles, place the first and second fingers of one of your hands into your vagina. Squeeze as if holding urine in until you feel a tightening around your fingers.
• Tightening these muscles is the exercise. Squeeze and hold for at least 10 seconds, then relax for 10 seconds. Repeat these exercises at least 10-20 times, 3 times per day. The more often you do the exercises, the more likely that they will work.

Create a urination diary. Take notes every day on your urination patterns. This will help your health care provider in diagnosing your problem:

• Time of urge to urinate (or if there was no urge)
• Strength of pain or urge
• Time you actually urinated
• Volume of urine
• Amount of leakage
• Type and amount of fluids you drink and when you drink them

A young but promising new treatment is biofeedback. It has been shown to make a significant difference in the pediatric population. Because many people with incontinence have pelvic floor dysfunction from unidentifiable causes, it is felt that bladder retraining may improve many people with incontinence. Biofeedback  consists of pelvic muscle tightening and relaxation with a trained technologist facilitating the sessions. This treatment does require a dedicated person but may eliminate the need for medications and/or surgery.

Follow-up

Follow the recommendations of your health care provider.

Make and keep regular follow-up appointments. You can discuss your progress with your provider, and he or she can tailor your treatment accordingly.

Prevention

The following measures can help maintain good bladder and urinary health:

• Drink plenty of fluids.
• Avoid alcohol and caffeine.
• Urinate regularly.
• Avoid foods that irritate your bladder.
• Maintain good health: Eat a healthy diet, maintain a health weight, and engage in some physical activity daily.

Follow up with your primary care provider on a regular basis.