Urinary Incontinence: Tips and Strategies

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Tips & strategies

Voiding diary

Before meeting with your doctor, take the time to keep a voiding diary for a few days. This diary is essential for analyzing the problem of urinary incontinence and will make it easier to choose the appropriate treatment.

How to fill it out

Ideally, you should choose some weekdays and some weekend days. Each day should be tracked for 24 consecutive hours, and each of the following columns needs to be properly filled out.

Bathroom visits

  • Check every time you use the bathroom to urinate.

Urine leakage

  • Check every time there is leakage, whether during a visith to the bathroom or not.

Reminder list for your medical appointment

  • I experience urine leakage when I cough, laugh, sneeze or make an effort.
  • I feel a strong need to urinate and I don’t have time to get to the bathroom.
  • I don’t notice my urine leakage or my desire to urinate.
  • I get up several times a night to urinate.
  • I am always going to the bathroom.
  • I need to change my urinary protection X times a day.
  • I don’t go out anymore, because I’m afraid I won’t be able to get to a bathroom in time.

Kegel exercises

For any type of urinary incontinence, exercises that strengthen the pelvic floor muscles can reduce symptoms by helping you hold while you find a bathroom. You will need to do them every day for 8 to 12 weeks before you can expect to see improvement. The benefits of these exercises will continue ONLY as long as you do them! Even 98-year-old women have managed to heal their incontinence after doing these exercises and eliminating tea from their diet!

You can print out a brochure (pdf) that explains how to do the exercises.

Take the leap! Talk about incontinence, you’ll feel better in the end!

 

You're not alone!

Meet Mina.

Mina is 92 years old and has been suffering from incontinence for ten years, but the situation recently got worse. She started going to the bathroom every two hours, with leakage (light to medium) on the way. She refuses to go out because she is afraid of having an "accident." Her daughter brought her to the doctor. The doctor suggested that she eliminate tea and replace it by hot water with sugar and lemon, or with milk (even better!); that she practice getting up and sitting, and walking every day in the hallways of her residence; that she use a higher, more rigid chair with arms; and that she practice Kegel exercises.

Improvements: Mina’s dietary changes reduced her bladder irritation, which in turn reduced her urges to urinate and so increased her control over them. The exercises, and the use of a better chair, helped her increase her mobility, which shortened the time it took Mina to get to the bathroom.

Meet Jean.

Jean is 74 years old, and complains of nocturnal incontinence. She needs to get up three to five times a night, and can’t get to the bathroom in time. She is so tired that her doctor has prescribed sleeping pills. Now, she only wakes up once or twice a night, but she often wets the bed. Her family is wondering if she should be placed in a residence. The doctor recommended that she elevate her legs for 30 to 60 minutes twice a day so that the water accumulating in her ankles during the day (vascular insufficiency of the lower limbs) can be redistributed and eliminated during the day instead of at night; that she take her diuretics in the morning instead of at night (some medications, like diuretics, cause the body to produce more urine), and that she avoid drinking before bed; that she get a walker, a women’s urinal, or a commode; and that she do Kegel exercices. The doctor also cancelled the sleeping pill prescription.

Improvements: Elevating her legs during the day helped Jean to limit swelling and reduce her need to urinate at night. Some medications, like diuretics, cause the body to produce more urine. Taking these medications in the morning also helped reduce her need to urinate at night. Since she wakes up less often at night to go to the bathroom, Jean sleeps better and no longer needs sleeping pills. Lastly, using a commode cuts down the time she needs to get to the bathroom. Jean now only gets up twice a night, and the doctor is satisfied with this, since it’s normal for her age.

Meet Juliette.

Juliette, 68 years old, has suffered from mixed urinary incontinence for about three years. She needs to wear urinary protection at all times because of the urine leakage she experiences when she has a sudden urge to urinate or when she coughs, sneezes or makes a physical effort. She has to find a bathroom as soon as she feels the need to urinate in order to avoid leakage as much as possible. She started an exercise program to reinforce her pelvic floor muscles, as well as a bladder retraining program. She also made changes to her diet to reduce bladder irritation.

Improvements: 12 weeks after making these changes (exercise, bladder retraining and dietary changes), Juliette considerably increased her ability to hold—by 80 %. At her first follow-up appointment, the doctor suggested she try a medication to reduce her urges to every 2 ½ hours. Juliette decided to take a small dose of a new urge incontinence medication. By the time of her second follow-up appointment, her incontinence was 95 % under control, but she still experienced urine leakage when she stood up from her chair. The doctor spoke to her about a non-invasive surgical procedure that might help (sling). Juliette was frightened, and opted instead for specialized physiotherapy to further strengthen the pelvic floor muscles. She left feeling reassured, knowing that there were other solutions for the future if they became necessary.

 

We are pleased to house this series of FAQs supervised by Cara Tannenbaum, from the Centre de recherche de l’Institut universitaire de gériatrie de Montréal.

Browse Contents of Urinary Incontinence:

The FAQs are also not meant to be a substitute for medical advice. When you have questions about your health, it is always advisable to ask a health care practitioner.

Health Professional Guide to Urinary Incontinence

The production of this content was supported by a Knowledge-to-Action partnership grant between the CWHN and the Canadian Institutes of Health Research and supervised by Dr Cara Tannenbaum from the Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal.