Behavioural treatments

Often, making simple behavioural modifications can help you reduce or eliminate incontinence.

Weight loss

Carrying extra weight, and in particular being obese, can make a difference when it comes to incontinence, because extra pounds of fat can strain the bladder and the muscles surrounding the bladder. You may find that losing just a little weight could make a positive difference.

Adequate fluids - reducing caffeine

It is important to avoid drinking too much fluid, as that can aggravate incontinence and make you go more often. However, it is also important to ensure you drink enough fluid on a daily basis to remain properly hydrated. If you don't drink enough fluids, your urine may be too concentrated, which can also irritate the bladder. You may also find it helpful to limit your intake of beverages that contain caffeine, which is a diuretic.

Kegel exercises

Kegel exercises are easy to do and can be done standing, sitting, or lying down. Because they help strengthen the urinary sphincter and pelvic floor muscles, they are also called pelvic muscle exercises or pelvic floor exercises. They are particularly helpful in the treatment of stress incontinence, which results from weak pelvic and bladder muscles.

Step 1. Find a comfortable position and place your knees about 25 cm (10 inches) apart.

Step 2. Squeeze or contract the muscles in your pelvis and rectum as if you are trying not to urinate or have a bowel movement. Do not tighten your stomach or buttocks.

Step 3. Hold the muscle contractions for 5 to 10 seconds, then relax for 10 seconds.

Step 4. Repeat steps 2 and 3 between 12 and 20 times a session, for 3 to 5 sessions a day.

Don't forget to breathe normally while doing your Kegel exercises, and keep your buttocks and stomach relaxed.

Let your doctor know that you are doing these exercises and check to make sure that you are doing them correctly.

Biofeedback

Biofeedback therapy is helpful in training your pelvic floor muscles and is often used together with Kegel exercises. It helps you perfect your exercises so you get maximum benefit from them. Administered in hospital outpatient settings and in clinics, biofeedback involves the gentle placement of electrodes into the body. The electrodes transmit information to a monitor on which you can see how well your pelvic muscles are working.

Bladder training

This is an extremely useful technique that can help you regain control over the number of times you go to the toilet. It is used either alone or in combination with other therapies, and it is particularly helpful for treating urge, stress, and mixed incontinence.

Essentially, you are retraining yourself to wait for at least 10 minutes after you get the urge to urinate before you go to the toilet. Over time you can gradually increase the 10-minute interval so that you are urinating once every 2 to 4 hours.

Fluid and diet management

Reducing your intake of foods and beverages that irritate your bladder will produce noticeable benefits. For example, reducing or eliminating caffeine, soda, alcohol, chocolate, and acidic foods such as tomatoes or tomato juice and citrus fruits is a good place to start. Foods and beverages that contain artificial sweeteners should also be avoided, as should very spicy foods. For nighttime incontinence, not drinking too close to bedtime may resolve, or at the very least reduce, your incontinence.

Dietary management can be used with bladder retraining or other techniques. Make sure that you continue to maintain an adequate fluid intake - try switching to water as your preferred drink.

Scheduled toilet times

This is an especially useful technique if you are caring for someone with incontinence.

It involves timing toilet trips according to the clock, rather than waiting until you or your loved one need to urinate. Typically, toilet trips can be scheduled every 2 to 4 hours. Some people may need to start by going to the bathroom every hour, then gradually increasing the time between scheduled toilet trips to every 2 to 4 hours.