The involuntary loss of urine when you cough, laugh or sneeze is called stress incontinence. The phenomenon is more common in women than in men. It can also happen when you run, lift heavy objects, or do any physical activity that increases pressure on your bladder. Unfortunately, stress incontinence can cause embarrassment and draw you away from friends and people, but it can also limit exercise and other recreational activities. However, by treating it (at home or with your doctor's assistance), you can manage and improve this disorder.
Steps
Part 1 of 2: Treating Stress Urinary Incontinence at Home
Step 1. Go to the bathroom often
If you postpone it, the problem of leaks could get worse. Go to the bathroom whenever you feel the need. Also, if you're traveling long distances, empty your bladder between stops whenever you can.
Step 2. Treat constipation
Constipation promotes stress incontinence because it increases abdominal pressure and stimulates the nerves near the rectum, thereby increasing the frequency of urination. When you are at home, you can take simple steps to treat constipation, including:
- Eat more fruits, vegetables, and high-fiber grains;
- Keep yourself hydrated;
- Keep yourself physically active.
- You can find more information in the article How to Regulate Bowel Movements.
Step 3. Eliminate foods and drinks that irritate the bladder
Various foods and drinks can cause bladder irritation or have a diuretic effect (in other words, they cause you to urinate more often). Your body may react to some of them, but not all of them. Try to identify them in your diet to understand which ones lead to increased stress incontinence. Among the most common foods and substances that aggravate this disorder consider:
- Caffeine;
- Sodas;
- Citrus fruits;
- Chocolate;
- Alcoholic beverages;
- Spiced foods.
Step 4. Reduce your fluid intake
If you are still experiencing incontinence even after choosing to eliminate bladder-irritating drinks, try decreasing your overall water intake. However, avoid getting dehydrated. Only reduce the amount of fluids you ingest if you already drink more than 8-10 glasses of water a day.
If your incontinence problem is more severe in the evenings and at night, limit your fluid intake after 4pm
Step 5. Stop smoking
In addition to promoting a long range of health complications, smoking can also irritate the bladder, cause symptoms of overactive bladder syndrome, and increase episodes of stress incontinence. In addition, the chronic cough that many smokers suffer from can increase the frequency of bleeding.
- There is rarely any results from quitting smoking overnight. Therefore, use smoking cessation methods, such as patches or nicotine gum. You can also contact a support group to fight smoking.
- To get rid of the habit of smoking, you can find more information in the article How to Quit Smoking.
Step 6. Get more physical activity
Being overweight can increase the pressure on the bladder and pelvic muscles. Experts consider overweight a body mass index (BMI) of at least 25 (30 indicates obesity). Even a moderate loss of a few pounds can help improve symptoms of stress incontinence.
- A great workout to lose a few extra pounds is to do moderate-intensity aerobic activity (such as brisk walking or cycling) for 30 minutes, 5 times a week. If you prefer a more vigorous workout (for example, playing a sport), go for 75 minutes per week.
- Note that weightlifting is not as effective as aerobic exercise for burning calories. In fact, the fact of habitually lifting a certain load risks compromising the resistance of the pelvic floor and, consequently, aggravating stress incontinence.
- For more information on calculating BMI, read the article How to Calculate Body Mass Index.
- Some doctors suggest using a tampon for stress incontinence symptoms when exercising (for example, running) to increase support within the vagina. Remember to take it off, otherwise you risk toxic shock syndrome.
Step 7. Eat a balanced diet
If you want to lose a few extra pounds, eating right is as essential as exercising. Eliminate processed foods, sugary foods and drinks, as well as dishes that are high in saturated fat. Then opt for a diet rich in fruits, vegetables, lean meats (fish and skinless chicken) and whole grains. Check with your doctor about the most effective changes you can make in your diet.
Step 8. Strengthen the pelvic floor muscles
Weakening of the pelvic muscles (often due to childbirth) is a major cause of stress incontinence. 75% of women suffering from this disorder are able to strengthen these muscles with Kegel exercises (men can do them too). Be patient as it may take weeks or months to see results.
- To perform Kegel exercises, the next time you go to the bathroom, voluntarily stop the flow of urine so you can understand which muscles are involved when urinating. Once you have learned how to use them, contract them for a count of 8 and relax them for a count of 10. Do 10 repetitions, 3 times a day.
- At first you can also calculate a shorter time and gradually increase it.
- To strengthen the pelvic muscles, you can also try using cone-shaped vaginal weights to insert into the vagina as if they were tampons. Start with a light weight and hold it for 1 minute, 2 times a day. Once you are able to hold it for a quarter of an hour, increase it.
- Yoga has also been shown to strengthen the pelvic floor muscles. The position of the fish, the mountain and the crow are just as effective as the Kegel exercises.
Step 9. Use some tricks to reduce the amount of leaks
The following steps take time. Even if you expect results from previous exercises, you can take other steps to reduce the frequency and amount of urine leaks. Try to:
- Cross your legs when you start laughing or need to cough or sneeze. This will help support your bladder and reduce pressure.
- Cover the underwear with specific products for stress incontinence. These are absorbents that prevent stains from forming on clothes and reduce the smell of urine.
- Contract your muscles and buttocks when sitting to reduce involuntary leaks.
Step 10. Monitor your blood sugar levels
If you are diabetic, changes in blood glucose values can lead to a greater frequency of stress incontinence episodes. So, check your glycemic index regularly and manage it by staying physically active and eating a balanced diet.
Part 2 of 2: See Your Doctor to Treat Stress Urinary Incontinence
Step 1. Know the right time to see your doctor
If your symptoms do not improve despite the steps described above or if the leaks begin to hinder your daily life, see your doctor. He will be able to tell you what steps to take based on the severity and other aspects of your case, including medications and surgery if the problem is serious.
Give your doctor a full picture of your medical history and let him know of all the remedies you have tried
Step 2. Undergo any diagnostic tests
Your doctor will perform a physical examination of your abdomen and genitals during which he may ask you to contract different muscles. He will likely prescribe diagnostic tests, including:
- Urinalysis to rule out infections, blood, or abnormalities that can increase bladder sensitivity or irritability
- Neurological tests to identify nerve lesions in the pelvis area;
- Sphincterometry, which allows you to observe the loss of urine as you cough or sink
- Flowmetry, which measures the amount of urine left in the bladder after urination and the pressure inside the bladder.
Step 3. Consult your doctor about drug therapies
Your doctor will likely encourage you not to abandon the methods and exercises described in the previous section (even advising you to increase these habits). In addition, he may prescribe a drug to reduce stress incontinence. Medicines useful in mild or moderate cases include:
- Anticholinergics: oxybutynin (Oxybutynin hydrochloride Mylan, Ditropan), tolterodine (Detrusitol) and trospium chloride (Sanctura), to relax the bladder muscles and reduce contractions and losses.
- Antimuscarinics: atropine, solifenacin, to stop bladder contractions (may increase the amount of urine left in the bladder after it is emptied).
- Imipramine: tricyclic antidepressant, which relaxes the muscles of the bladder to promote complete evacuation.
- Estrogen creams, pessaries or vaginal rings to strengthen pelvic floor muscles in women who have gone through menopause.
Step 4. Consult your doctor about surgical options
If all other solutions have failed to relieve the symptoms of stress incontinence, your doctor may suggest surgery as a last resort. His opinion will be based on gender and other criteria. Surgical procedures include:
- Repair of the anterior vaginal wall: restores the firmness of the vaginal walls in case of bladder prolapse (the bladder slips from its seat towards the vagina).
- Artificial Urinary Sphincter: Device used primarily in men to stop urine leaks.
- Collagen injections: Strengthen the area around the urethra to reduce leakage. This option may require several sessions.
- Retropubic suspension: Surgical procedure that lifts the bladder and urethra to reduce strain and pressure.
- Pubo-vaginal sling: an operation that consists in inserting strips of material under the urethra in order to reduce effort and pressure.
