About Your Diagnosis
Urinary incontinence is the uncontrollable loss of urine. The two most
common types of incontinence are "stress incontinence" and
"urge incontinence." If you lose urine in a spurt or gush
with a cough or sneeze, you probably have stress incontinence. If you
lose urine on the way to the toilet because you waited too long or run
to the toilet frequently (every 12 hours), you probably have urge
Stress incontinence can be caused by childbirth or growing older. Urge
incontinence can be caused by medication, too much caffeine or alcohol,
or growing older. Many women notice bladder problems worsen at the time
Urinary incontinence is very common. It is estimated that up to 60%
of women have incontinence. The type of urinary incontinence can be
diagnosed with "urodynamic testing." Fortunately, most cases
of urinary incontinence can be cured or at least improved significantly.
Living With Your Diagnosis
If you occasionally leak a very small amount of urine with a cough or
sneeze, or on the way to the toilet, you have very mild incontinence
and you may not be interested in treating it. Usually, treatment requires
some time and effort. If you leak daily and/or wear a pad for protection,
you have mild-to-moderate incontinence and may definitely be interested
in treatment options. If you can soak a pad when you lose urine and
do it frequently (several times each day), you have severe incontinence.
If you have moderate or severe incontinence, you may have found yourself
restricting your activities or not going out as much as previously.
Fortunately, there are many treatment options available for urinary
incontinence. Strengthening the pelvic floor muscles is usually the
first step to cure stress incontinence. Contracting the pelvic floor
muscles is called "Kegel" exercise. A Kegel is done by pulling
in the pelvic floor muscles; it should feel like you are pulling in
your rectum or "sucking up water with you pelvic floor." Make
sure you are performing the Kegel exercises correctly by having someone
observe you who knows what a correct Kegel is. Usually, 4050 Kegels
are recommended each day, i.e., 10 Kegels in a row, 4 or 5 sets each
day. Also, it is very important that you try to Kegel (tighten your
pelvic floor muscles) when you cough, sneeze, or lift something.
If Kegel exercises do not seem to help, you may be referred for physical
therapy to help improve bladder control. Specialized physical therapy
for the pelvic floor muscle includes biofeedback and/or functional electrical
stimulation. This type of physical therapy is usually done in special
More recently, special types of pessaries have been designed to treat
stress incontinence. Sometimes pessaries are very useful for women who
only lose urine during certain activities such as jogging, aerobics,
and horseback riding, but are otherwise fine. These incontinence pessaries
can be placed before the activity and then removed after the activity
or left in all day.
Usually, the first step in treating urge incontinence is bladder training.
Bladder training is done by voiding (emptying your bladder) at certain
intervals. The intervals are gradually lengthened. The goal is to be
able to go 3 hours before voiding during the daytime without any episodes
of leaking. Sometimes medication is prescribed to help with the bladder
training. Medications used to treat urge incontinence may cause some
dryness of the mouth or eyes. This side effect is expected and as long
as the dryness is tolerable, the medication can be continued.
Surgery can also be used to resolve stress incontinence. There are a
variety of different types of surgical procedures. The type of surgical
procedure that is best for you should be discussed by you and your specialist.
The specialist may be a gynecologist or a urologist.
* Do your Kegel exercises as directed. Sometimes a good place to remember
to do them is in the car every time you come to a red light or stop
* Take your medication (if one is prescribed) as directed.
* Avoid drinking lots of liquids with caffeine in it such as coffee,
black tea, and sodas with caffeine (Coca Cola, Pepsi). Caffeine is a
diuretic; it makes the kidneys produce more urine at a faster-than-normal
rate. This will make both stress and urge incontinence worse, and can
cause frequent urination as well.
* Avoid drinking excessive amounts of alcoholic beverages such as beer
and wine. Alcohol is a diuretic as well, so it will also make stress
and urge incontinence worse. Alcohol can also cause increased urinary
* Avoid drinking excessive amounts of liquid during the day; most individuals
do not need more than 64 ounces (eight 8-ounce glasses) of liquid each
day. Also, avoid drinking a lot of fluid at one time. It is better to
space out fluid intake evenly during the day.
* If you get up more than twice during the night to urinate, avoid drinking
liquids after 78 pm.
When to Call Your Doctor
* If your symptoms are not improving.
* If you cannot tolerate the side effects of any prescribed medication.
For More Information
Alliance for Aging Research
2021 K Street, N.W., Suite 305
Washington, DC 20006
Help For Incontinent People
PO Box 544
Union, SC 29379
Simon Foundation for Continence
Wilmette, IL 60091
800-23-SIMON or 708-864-3913