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Urinary incontinence in women Q&As

Published by Bupa's health information team, January 2009.

Answers to questions about urinary incontinence in women

This section contains answers to common questions about this topic. Questions have been suggested by health professionals, website feedback and requests via email.

 

What are pelvic floor exercises and how do I do them?

Pelvic floor exercises have been shown to be an effective treatment for both stress and mixed incontinence. They may also be useful in helping people who have urge incontinence if they are used along with bladder training. To get the full benefit of pelvic floor exercises you need to exercise your muscles several times a day, for at least three months. A training programme of exercises should be developed for each person, to take account of their individual condition.

Explanation

If you have stress or mixed incontinence you will be asked to try pelvic floor exercises to see whether they improve your incontinence. Most women are offered this treatment first, before medicines or surgery. Sometimes women have mild pain or discomfort when they do the exercises, but usually this treatment has no side-effects at all.

Pelvic floor exercises have to be done regularly over a period of at least three months before you can tell for certain whether they are working for you. If they have worked you will need to do them for the rest of your life to maintain the benefits. Do keep going with exercises, as for many women they can help a lot.

The important points about doing pelvic floor exercises are listed below.

  • The best way to learn them is to be taught by a physiotherapist or by a continence nurse. You can ask your GP to refer you.
  • First, you need to find your pelvic floor muscles before you can exercise them. Imagine you are trying to stop yourself from passing urine and wind at the same time. Tighten the muscles around your vagina, your urethra (the tube that urine leaves your body from) and your back passage. You are tightening your pelvic floor muscles.
  • It's easy to tighten other muscles as well, which you don't need to do. So, try not to squeeze your buttocks or legs together. Hold your breath or hold in your tummy muscles.
  • It's helpful to do two different kinds of exercises. Firstly, tighten your muscles for as long as you can, up to ten seconds and repeat ten times. Secondly, you can do shorter quicker exercises, holding for a second and letting go. Repeat ten times. You can do either, or both, of these exercises.
  • Do at least eight sets of exercises, three times a day. You can do them while you are standing, sitting or lying down, and you can do them whenever you wish. No one can see you do them. Some women find it helpful to set up a routine for their exercises, for example, doing a set every time they wash their hands.
  • Along with pelvic floor exercises some women find other treatments like vaginal cones and biofeedback can help. Talk to your GP or nurse for more information and to see whether these might be useful for you.

Further information

Sources

  • Management of urinary incontinence in primary care. Scottish Intercollegiate Guidelines Network. 2006 (SIGN). www.sign.ac.uk
  • The pelvic floor and stress incontinence. The Continence Foundation, 2004. www.continence-foundation.org.uk, accessed 28 March 2008
  • Urinary incontinence: the management of urinary incontinence in women. National Institute for Health and Clinical Excellence (NICE). 2006. www.nice.org.uk
  • Simon C, Everitt H, Kendrick T. Oxford Handbook of General Practice. 2nd ed. Oxford: Oxford University Press, 2007: 711
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What else can I do make things feel better day to day?

Incontinence can have a major impact on your life, affecting your work, relationships, social life and emotional wellbeing. Many women are too embarrassed to get help and some see it as a natural part of getting older. However, as well as medicines, surgery and techniques like pelvic floor exercises. There are many things that you can do for yourself that will help you to feel more comfortable and in control.

Explanation

Incontinence can affect any part of your life, from your job, to how you spend your spare time, to the relationships you have with your partner and family. You may find yourself avoiding social situations and worrying about going out or spending time away from home. Your sexual relationships may also suffer.

Because of the effect incontinence can have on your life, it's important not to ignore it and to seek help as soon as the problem starts. Around one in three women never seek help and suffer in silence. The first step is to talk to your nurse or GP or to someone who knows how you are feeling. There are organisations that can help by providing you with information and support. By getting the right information and advice, talking about your feelings and concerns and getting the practical help that you need you should start to feel better and more in control. There is likely to be a specialist continence nurse in your area who will see many women like you and who can offer you specialist advice. Ask your GP to refer you.

There are a number of practical tips that might help you. Some examples include the following.

  • Try not to get constipated as this can make things worse. To prevent constipation eat plenty of fruit, vegetables and fibre in your diet. Make sure you are drinking enough fluid (six to eight glasses or cups a day) and stay active.
  • If you take diuretic medicines (water tablets) for a health condition like high blood pressure, they may affect your incontinence. Try varying the times when you take your tablets and ask your GP whether there are any other medicines that you could try.
  • You could try the wide range of pads and knickers available to suit different needs. For example, you might want something slim and discreet during the day but something more bulky at night. You can buy pads from the chemist or your nurse can order them for you.
  • Look after your skin. Urine can cause irritation - as well as leaving your skin red and sore it can cause it to break down. Clean and dry your skin thoroughly as soon as possible after any incontinence.

Further information

Sources

  • Urinary incontinence: the management of urinary incontinence in women. National Institute for Health and Clinical Excellence (NICE). 2006. www.nice.org.uk
  • Simon C, Everitt H, Kendrick T. Oxford Handbook of General Practice. 2nd ed. Oxford: Oxford University Press, 2007: 694-697
  • Alexander M. Fawcett J, Runciman P. Nursing practice: hospital and home: the adult. 3rd ed. Churchill Livingstone Elsevier: London, 2006: 869
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What is bladder training?

Bladder training is a treatment that can help if you have urge incontinence or mixed incontinence. It works best if your symptoms are mild. Bladder training means learning how to ignore or suppress the need to pass urine. Eventually you will have fewer strong urges to pass urine and can get into a more regular pattern. You will need to try bladder training for at least six weeks to know whether it's working or not.

Explanation

Bladder training works by increasing the time between each visit to the toilet, and so increasing the amount of urine you pass each time you go. Learning how to train your bladder is something that is done most effectively when your nurse can help you, but it's possible for you to learn how to train your bladder yourself. The four steps to bladder training are as follows.

  • Keep a record of when you are going to the toilet to pass urine. You can also measure how much you are passing by measuring it in a jug. Do this for one week.
  • Work out, on average, how often you are going to the toilet to pass urine and how much you are passing. Set your first target to improve on this. For example, if you pass urine every hour, set your first target to pass urine every hour and a half.
  • To hold on for this extra time you are going to need to distract yourself. Sitting on a hard chair or a rolled up towel can help, as can squeezing your pelvic floor muscles. You may need to take small steps to get to your target, for example, increasing by five minutes at a time.
  • Once you have achieved your target, set a new one. Keep going until you are going to the toilet to pass urine every three or four hours and your symptoms of urgency have gone. It can take several months to get to this stage.

Further information

Sources

  • Urinary incontinence: the management of urinary incontinence in women. National Institute for Health and Clinical Excellence (NICE). 2006. www.nice.org.uk
  • Management of urinary incontinence in primary care. Scottish Intercollegiate Guidelines Network (SIGN). 2006. www.sign.ac.uk
  • The overactive bladder. The Continence Foundation. 2004. www.continence-foundation.org.uk, accessed 28 March 2008
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Related topics

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This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.

Publication date: January 2009

 

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