Strengthen your pelvic floor

Your pelvic floor muscles and urinary sphincter help control urination. You can strengthen these muscles by regularly doing pelvic floor exercises, commonly referred to as Kegels. The pelvic floor muscles work to open and close the urethra — the tube that carries urine from the bladder to the exterior of your body. These muscles also support the bladder as you exert yourself doing everyday activities such as walking, standing, lifting and sneezing.

  • Practice Kegel exercises. To perform Kegels, squeeze your pelvic floor muscles as if you're trying to stop your stream of urine. Your doctor may recommend that you do a set of these exercises three or four times a day to treat your bladder control problem. Kegels are especially effective for women with stress incontinence, but they can also help reduce or eliminate urge incontinence. You may want to ask your doctor for help or to refer you to a specialist who can teach you the proper way to do these exercises, because many people unknowingly practice incorrectly. When you're first learning Kegels, it's most effective to practice them while lying down in a quiet place. This way you can concentrate better.
  • Biofeedback. Biofeedback is a behavior therapy that's used to help train pelvic floor muscles. Sensors are placed near the muscles that are being monitored. The sensors transmit exertion levels to a computer, which displays the levels on the screen. This immediate feedback helps some people master Kegel exercises faster because they can see whether they're using the correct muscles. Biofeedback can be done with a health care provider or with a home device. The idea is that once you've had enough feedback, you can confidently do the exercises on your own without the equipment.
  • Vaginal weights. Cone-shaped weights are another option used to help with Kegel exercises. You place a weight in your vagina and contract your pelvic floor muscles to keep it from falling out. Many cones come in sets of varying weight levels, so you can build up to heavier weights as your pelvic floor muscles become stronger.

Control contributing factors

Certain medications, excess weight, smoking and physical inactivity may indirectly contribute to bladder control problems. If you address these factors, bladder-specific techniques — such as avoiding bladder irritants and bladder training — may be even more likely to work.

  • Manage your medications. Examples of drugs that may contribute to bladder control problems include high blood pressure drugs, heart medications, diuretics, muscle relaxants, antihistamines, sedatives and antidepressants. If you develop problems with incontinence or difficulty urinating while taking these drugs, talk to your doctor. You may be able to avoid urinary side effects by taking another medicine.
  • Maintain a healthy weight. Being overweight may contribute to bladder control problems, particularly stress incontinence. Excessive body weight puts pressure on your abdomen and bladder, sometimes resulting in leakage. If you're overweight and experiencing a bladder control problem, losing weight may be one way to help.
  • Stop smoking. Smokers are more likely to have bladder control problems and are more likely to experience more-severe symptoms. Heavy smokers also tend to develop a chronic cough, which can place added pressure on the bladder and aggravate urinary incontinence. Improving urinary incontinence may be one of many benefits of stopping smoking.
  • Start exercising. Some studies indicate that regular physical activity reduces bladder control problems. Try for at least 30 minutes of moderate activity — such as walking briskly, biking or swimming — most days of the week.
  • Minimize constipation. Straining excessively during bowel movements can damage the pelvic floor. And unfortunately, some medications used to treat bladder control problems can make constipation worse. Exercising, drinking enough water and eating high-fiber foods, such as lentils, beans, and fresh vegetables and fruit, may help improve constipation.
  • Manage chronic cough. If you have a cough that doesn't go away, it could make your bladder control problem worse. Smoking is a common cause of chronic cough. If you don't smoke, the cough could be caused be a treatable condition, such as allergies or a sinus infection.

Your role in treatment

Behavior therapies can improve bladder control with minimal side effects. These techniques take some time and practice before you begin seeing results. But persistence pays off. If you stick with the program, you'll more than likely see an improvement in your symptoms. And if one of these approaches doesn't work, talk with your doctor about exploring other treatment options that may help.

Jul. 30, 2011 See more In-depth