URINARY INCONTINENCE: WOMEN
PROBLEM
Urinary incontinence is when you leak
or are unable to hold your urine. Incontinence is not considered a normal part of aging.
CAUSE
The cause depends on the type of incontinence you have. Incontinence is common in conditions that cause pressure on the bladder, such as pregnancy, chronic coughing, obesity, menopause, pelvic organ prolapse, and certain neurologic problems:
A.Functional incontinence—Lose urine because you are unable to get to the bathroom.
B.Urge—Unable to delay emptying your bladder after the sensation of fullness is felt. May leak urine when hearing running water, placing hands in water, or trying to get into the bathroom.
C.Overflow—Loss of urine when the bladder is too full.
D.Stress—Unable to hold your urine during coughing, sneezing, laughing, bending over, or other physical activity.
E.Overactive bladder—Stress incontinence with or without urge incontinence. Symptoms include urgency, frequency, and getting up to empty your bladder one or more times a night.
PREVENTION
Exercise regularly and practice pelvic floor exercises, commonly called Kegel exercises. Do not become constipated, so you do not strain to have a bowel movement. Stop smoking. If you have a cough, you may need to see your healthcare provider to help treat it.
TREATMENT PLAN
Treatment depends on cause and type of incontinence. Fill out the bladder diary (see Table III.8) and return it to your provider to help figure out what kind of problem you have:
A.Pelvic floor exercises should be done every morning, afternoon, and evening; repeat the exercise five times for each set, and gradually increase to 10 times each set. To perform these exercises:
1.Start by doing your pelvic muscles exercises lying down. When your muscles get stronger, do your exercises sitting or standing.
2.Do not tighten your tummy, leg, or butt muscles, just squeeze the muscles you use to start and stop the flow of urine.
3.Do not hold your breath or practice while you are on the toilet urinating.
4.Pull in pelvic muscles and hold them tight for a count of five.
5.Repeat five times.
6.Work up to doing three sets of 10 repeats.
7.Kegel exercises take just a few minutes a day, and most women notice an improvement after a few weeks of daily exercise.
B.Empty your bladder frequently. As soon as you feel the urge to urinate, go to the bathroom. You may need to go to the bathroom on a timed schedule.
C.You may be taught relaxation techniques to control the feeling of having to go quickly.
D.Avoid becoming constipated and having to strain down to have a bowel movement.
Activity: Try to get daily exercise. Use absorbent undergarments until your bladder leaking is under control.
Diet: Eat a well-balanced diet. If you are overweight, consider a weight-loss program. Avoid drinking lots of liquids, especially caffeinated beverages and alcohol.
Medications: What you take depends on the type of bladder leakage you have.
You Have Been Prescribed: ___________________________________________________________
You Need to Take: ___________________________________________________________
You Need to Notify the Office If You Have: ___________________________________________________________
Phone: ____________________________
RESOURCES
American Urogynecologic Society: www.augs.org
American Urological Association: www.UrologyHealth.org
National Association for Continence: www.nafc.org
The Simon Foundation for Continence: www.simonfoundation.org
YOUR DAILY BLADDER DIARY
This diary will help you and your healthcare team figure out the causes of your bladder-control trouble. The sample line shows you how to use the diary. Use this sheet as a master for making copies that you can use as a bladder diary for as many days as you need.
PATIENT TEACHING GUIDE