Urinary Incontinence and Vaginal Prolapse
SELF-MANAGEMENT FOR URGE INCONTINENCE
A. LIFESTYLE CHANGES
Urge incontinence is caused by an overactive bladder muscle, which can often be improved by reducing bladder irritants. This may involve making lifestyle changes such as avoiding certain foods and drinks that can irritate the bladder. For example:
Caffeine: Found in coffee, tea, cola, and chocolate
Alcohol
Cigarettes
Artificial sweeteners
Spicy foods
Citrus fruits
Regular toileting every 2-3 hours can also help some women with urge incontinence by preventing episodes of leakage.
Other important lifestyle changes to help improve both urge and stress incontinence, as well as fecal incontinence, include:
Achieving a healthy weight through a balanced diet and regular exercise
Drinking 6-8 cups of fluid per day, with two-thirds of it being water
Avoiding constipation, as it can exacerbate incontinence
B. BLADDER RETRAINING
For those with urgency or urge incontinence, bladder retraining can be an effective way to regain control over urinary urges and reduce leakage. Bladder retraining involves learning how to control the bladder muscle better. It helps suppress the urge to urinate until it's a more convenient time.
How to Perform Urge Suppression and Bladder Retraining:
Stop what you're doing when you feel the urge to urinate.
Sit down and squeeze your pelvic floor muscles. This is known as the “freeze and squeeze” technique.
Take a few deep breaths to help relax both your body and mind.
Distract your mind by counting backward, saying the alphabet, or reciting nursery rhymes.
Once the urge fades, walk calmly to the toilet.
If you experience common triggers for urge incontinence, such as hearing running water or putting your key in the door, try practicing the freeze and squeeze technique when confronted with these triggers. Over time, you’ll be able to better control the urge.
Important note: Although bladder retraining can help reduce leaking, it may not stop it entirely. It’s advisable to continue using pads as a backup.
Using Incontinence Pads: If you wear pads regularly, it’s important to use a barrier cream to prevent skin irritation.
C. PELVIC FLOOR MUSCLE EXERCISES
Strengthening the pelvic floor muscles is a key way to control both bladder and bowel function, as well as support the pelvic organs. Pelvic floor exercises can improve stress incontinence, urge incontinence, and pelvic organ prolapse.
What is the Pelvic Floor? The pelvic floor consists of muscles that stretch like a trampoline from the tailbone (coccyx) to the pubic bone (front to back) and from one sitting bone to the other (side to side). These muscles help support the bladder, uterus, and bowel. The pelvic floor muscles normally surround the openings of the urethra (for the bladder), vagina, and anus, helping to keep them closed.
Pelvic Floor Exercises (Kegel Exercises): These exercises strengthen the pelvic floor muscles, and many women find it helpful to receive coaching from a physiotherapist trained in pelvic floor health to get started properly.
How to Find the Right Muscles:
Imagine you are trying to stop the flow of urine or hold back gas.
You should feel the muscles around your vagina and anus tighten.
To check if you’re using the correct muscles, lie down and insert a clean, moist finger into your vagina. Tighten your pelvic floor muscles; you should feel a squeeze around your finger.
When contracted, the pelvic floor muscles help lift the pelvic organs and tighten the sphincters that control the urethra, vagina, and anus.
How to Do the Exercises:
Start lying down with your knees bent.
Squeeze your pelvic floor muscles and hold for 5-10 seconds, then relax for 10 seconds.
Work your way up to repeating this exercise 5-10 times.
Repeat these exercises 2-3 times a day.
As you improve, challenge yourself by doing the exercises while sitting, standing, walking, or even jumping. Gradually increase repetitions and reduce rest time.
Tips for Doing Exercises at Home:
Make sure you're only using the pelvic floor muscles, not your legs or buttocks.
Avoid holding your breath while doing the exercises.
"The knack": Use the pelvic floor muscles before coughing, sneezing, laughing, or lifting something heavy. This helps protect against leakage.
Remember:
Link your pelvic floor exercises to daily activities such as morning routines, watching TV, or waiting at red lights.
Place red dots or reminders around the house to help you remember to do your exercises.
It may take 3 to 6 months to see full results from pelvic floor exercises. You can test your pelvic floor strength by trying to stop your urine flow, but do not perform exercises while urinating, as this can confuse the bladder.
Contact a Maud Medical Professional to learn more.
