When you have urinary incontinence

  • Description
    • You have urinary incontinence. This means you are not able to keep urine from leaking from your urethra. This is the tube that carries urine out of your body from your bladder. Urinary incontinence may occur because of aging, surgery, weight gain, neurologic disorders, or childbirth. There are many things you can do to help keep urinary incontinence from affecting your daily life.

  • Alternative Names
    • Loss of bladder control - care at home; Uncontrollable urination - care at home; Stress incontinence - care at home; Bladder incontinence - care at home; Pelvic prolapse - care at home; Leakage of urine - care at home; Urinary leakage - care at home

  • Skin Care
    • You may need to take special care of the skin around your urethra. These steps may help.

      Clean the area around your urethra right after urinating. This will help keep the skin from getting irritated. It will also prevent infection. Ask your health care provider about special skin cleaners for people who have urinary incontinence.

      • Using these products will often not cause irritation or dryness.
      • Most of these do not need to be rinsed off. You can just wipe the area with a cloth.

      Use warm water and wash gently when bathing. Scrubbing too hard can hurt the skin. After bathing, use a moisturizer and a barrier cream.

      • Barrier creams keep water and urine away from your skin.
      • Some barrier creams contain petroleum jelly, zinc oxide, cocoa butter, kaolin, lanolin, or paraffin.

      Ask your provider about deodorizing tablets to help with odor.

      Clean your mattress if it becomes wet.

      • Use a solution of equal parts white vinegar and water.
      • Once the mattress has dried, rub baking soda into the stain, and then vacuum off the baking powder.

      You can also use water-resistant sheets to keep urine from soaking into your mattress.

  • Diet
    • Eat healthy foods and exercise regularly. Try to lose weight if you are overweight. Being too heavy will weaken the muscles that help you stop urinating.

      Drink plenty of water:

      • Drinking enough water will help keep odors away.
      • Drinking more water may even help reduce leakage.

      DO NOT drink anything 2 to 4 hours before going to bed. Empty your bladder before going to bed to help prevent urine leakage during the night.

      Avoid foods and beverages that can make urine leakage worse. These include:

      • Caffeine (coffee, tea, some sodas)
      • Carbonated drinks, such as soda and sparkling water
      • Alcoholic beverages
      • Citrus fruits and juices (lemon, lime, orange, and grapefruit)
      • Tomatoes and tomato-based foods and sauces
      • Spicy foods
      • Chocolate
      • Sugars and honey
      • Artificial sweeteners
      • Milk and milk products

      Get more fiber in your diet, or take fiber supplements to prevent constipation.

      Follow these steps when you exercise:

      • DO NOT drink too much before you exercise.
      • Urinate right before you exercise.
      • Try wearing pads to absorb leakage or urethral inserts to block the flow of urine.
  • Controlling the Need to Urinate
    • Some activities may increase leakage for some people. Things to avoid include:

      • Coughing, sneezing, and straining, and other actions that put extra pressure on the pelvic muscles. Get treatment for a cold or lung problems that make you cough or sneeze.
      • Very heavy lifting.

      Ask your provider about things you can do to ignore urges to pass urine. After a few weeks, you should leak urine less often.

      Train your bladder to wait a longer time between trips to the toilet.

      • Start by trying to hold off for 10 minutes. Slowly increase this waiting time to 20 minutes.
      • Learn to relax and breathe slowly. You can also do something that takes your mind off your need to urinate.
      • The goal is to learn to hold the urine for up to 4 hours.

      Urinate at set times, even if you do not feel the urge. Schedule yourself to urinate every 2 to 4 hours.

      Empty your bladder all the way. After you go once, go again a few minutes later.

      Even though you are training your bladder to hold in urine for longer periods of time, you should still empty your bladder more often during times when you might leak. Set aside specific times to train your bladder. Urinate often enough at other times when you are not actively trying to train your bladder to help prevent incontinence.

      Ask your provider about medicines that may help.

      Surgery may be an option for you. Ask your provider if you would be a candidate.

  • Pelvic Floor Muscle Strengthening
    • Your provider may recommend Kegel exercises. These are exercises in which you tighten the muscles that you use to stop urine flow.

      You may learn how to do these exercises correctly using biofeedback. Your provider will help you learn how to tighten your muscles while you are being monitored with a computer.

      It may help to have formal pelvic floor physical therapy. The therapist can give you guidance on how to do the exercises to get the most benefit.

  • References
    • Freund K. Approach to women's health. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 237.

      Goode PS, Burgio KL, Richter HE, Markland AD. Incontinence in older women. JAMA. 2010;303(21):2172-2181. PMID: 20516418

      Hashim H, Abrams P. Evaluation and management of men with urinary incontinence. In: Wein AJ, Kavoussi LR, Partin AW, Peters CA, eds. Campbell-Walsh Urology. 11th ed. Philadelphia, PA: Elsevier; 2016:chap 72.

      Newman DK, Burgio KL. Conservative management of urinary incontinence. In: Wein AJ, Kavoussi LR, Partin AW, Peters CA, eds. Campbell-Walsh Urology. 11th ed. Philadelphia, PA: Elsevier; 2016:chap 80.