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When you have urinary incontinence

Loss of bladder control - care at home; Uncontrollable urination - care at home; Stress incontinence - care at home; Bladder incontinence - care at home; Pelvic prolapse - care at home; Leakage of urine - care at home; Urinary leakage - care at home

You have urinary incontinence. This means you are not able to prevent urine from leaking from your urethra. This is the tube that carries urine out of your body from your bladder. Urinary incontinence may occur because of aging, surgery, weight gain, neurologic disorders, or childbirth. There are many things you can do to help keep urinary incontinence from affecting your daily life.

Skin Care

You may need to take special care of the skin around your urethra. These steps may help.

Clean the area around your urethra right after urinating. This will help keep the skin from getting irritated. It will also prevent infection. Ask your health care provider about special skin cleaners for people who have urinary incontinence.

  • Using these products will often not cause irritation or dryness.
  • Most of these do not need to be rinsed off. You can just wipe the area with a cloth.

Use warm water and wash gently when bathing. Scrubbing too hard can hurt the skin. After bathing, use a moisturizer and a barrier cream.

  • Barrier creams keep water and urine away from your skin.
  • Some barrier creams contain petroleum jelly, zinc oxide, cocoa butter, kaolin, lanolin, or paraffin.

Ask your provider about deodorizing tablets to help with odor.

Clean your mattress if it becomes wet.

  • Use a solution of equal parts white vinegar and water.
  • Once the mattress has dried, rub baking soda into the stain, and then vacuum off the baking powder.

You can also use water-resistant sheets to keep urine from soaking into your mattress.

Diet

Eat healthy foods and exercise regularly. Try to lose weight if you are overweight. Being too heavy will weaken the muscles that help you stop urinating.

Drink plenty of water:

  • Drinking enough water will help keep odors away.
  • Drinking more water may even help reduce leakage.

Do not drink anything 2 to 4 hours before going to bed. Empty your bladder before going to bed to help prevent urine leakage during the night.

Avoid foods and beverages that can make urine leakage worse. These include:

  • Caffeine (coffee, tea, some sodas)
  • Carbonated drinks, such as soda and sparkling water
  • Alcoholic beverages
  • Citrus fruits and juices (lemon, lime, orange, and grapefruit)
  • Tomatoes and tomato-based foods and sauces
  • Spicy foods
  • Chocolate
  • Sugars and honey
  • Artificial sweeteners

Get more fiber in your diet, or take fiber supplements to prevent constipation.

Follow these steps when you exercise:

  • Do not drink too much before you exercise.
  • Urinate right before you exercise.
  • Try wearing pads to absorb leakage or urethral inserts to block the flow of urine.

Controlling the Need to Urinate

Some activities may increase leakage for some people. Things to avoid include:

  • Coughing, sneezing, and straining, and other actions that put extra pressure on the pelvic muscles. Get treatment for a cold or lung problems that make you cough or sneeze.
  • Very heavy lifting.

Ask your provider about things you can do to ignore urges to pass urine. After a few weeks, you should leak urine less often.

Train your bladder to wait a longer time between trips to the toilet.

  • Start by trying to hold off for 10 minutes. Slowly increase this waiting time to 20 minutes.
  • Learn to relax and breathe slowly. You can also do something that takes your mind off your need to urinate.
  • The goal is to learn to hold the urine for up to 4 hours.

Urinate at set times, even if you do not feel the urge. Schedule yourself to urinate every 2 to 4 hours.

Empty your bladder all the way. After you go once, go again a few minutes later.

Even though you are training your bladder to hold in urine for longer periods of time, you should still empty your bladder more often during times when you might leak. Set aside specific times to train your bladder. Urinate often enough at other times when you are not actively trying to train your bladder to help prevent incontinence.

Ask your provider about medicines that may help.

Surgery may be an option for you. Ask your provider if you would be a candidate.

Pelvic Floor Muscle Strengthening

Your provider may recommend Kegel exercises. These are exercises in which you tighten the muscles that you use to stop urine flow.

You may learn how to do these exercises correctly using biofeedback. Your provider will help you learn how to tighten your muscles while you are being monitored with a computer.

It may help to have formal pelvic floor physical therapy. The therapist can give you guidance on how to do the exercises to get the most benefit.

Open References

References

Newman DK, Burgio KL. Conservative management of urinary incontinence: behavioral and pelvic floor therapy and urethral and pelvic devices. In: Partin AW, Dmochowski RR, Kavoussi LR, Peters CA, eds. Campbell-Walsh-Wein Urology. 12th ed. Philadelphia, PA: Elsevier; 2021:chap 121.

Patton S, Bassaly RM. Urinary incontinence. In: Kellerman RD, Rakel DP, Heidelbaugh JJ, Lee EM, eds. Conn's Current Therapy 2023. Philadelphia, PA: Elsevier; 2023:1174-1176.

Resnick NM. Urinary incontinence. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 23.

  • Urinary incontinence

    Animation

    •  

    Urinary incontinence - Animation

    When you enter a store or restaurant, are you often looking to find the establishments bathroom? If you're having trouble holding in your urine, or if you often leak urine, you probably have what's called urinary incontinence. Normally, the bladder begins to fill with urine from the kidneys. The bladder stretches to allow more and more urine. You should feel the first urge to urinate when there is about 200 mL, just under 1 cup of urine stored in your bladder. A healthy nervous system will respond to this stretching sensation by letting you know that you have to urinate. But, at the same time, the bladder should keep filling. But the system doesn't work correctly in people with urinary incontinence. Some people with urinary incontinence leak urine during activities like coughing, sneezing, laughing, or exercise. This is called stress incontinence. When you have a sudden, strong need to urinate, but can't make it to the bathroom before you do urinate, it's called urge incontinence. Other people have what's called overflow incontinence, when the bladder cannot empty and they dribble. Urinary incontinence can have many causes, and it's most common in older adults. Women are more likely than men to have it. For some people the bladder muscle is overactive. For others, the muscles holding the urine in are weak. And for others, the problem is sensing when the bladder is full. They might have brain or nerve problems, dementia or other health problems that make it hard to feel and respond to the urge to urinate, or problems with the urinary system itself. To treat urinary incontinence, your doctor can help you form a treatment plan. Most likely, exercises to strengthen the muscles of your pelvic floor will be part of that plan. Bladder training exercises can also be effective. And depending on the cause of incontinence, oral medications, or topical estrogen may be helpful. If you have overflow incontinence and cannot empty your bladder completely, you may need to use a catheter. Your doctor can recommend the best catheter for you. For urine leaks, you might wear absorbent pads or undergarments. Whatever else you try, lifestyle changes may help. Aim for an ideal weight. Losing excess weight and increasing exercise both often improve incontinence, especially in women. Also, some specific beverages and foods might increase leaking in some people. For instance, you might try eliminating alcohol, caffeine, carbonated beverages, even decaf coffee. Drink plenty of water, but do NOT drink anything 2 to 4 hours before going to bed. Be sure to empty your bladder before going to bed to help prevent urine leakage at night. Throughout the day, urinate at set times, even if you do not feel the urge. Schedule yourself every 3 to 4 hours. Urinary incontinence is very common, but many people never talk to their doctor about it. Don't let that be you. See your doctor and bring it up at your next doctor's visit.

  • Urinary incontinence

    Animation

    •  

    Urinary incontinence - Animation

    When you enter a store or restaurant, are you often looking to find the establishments bathroom? If you're having trouble holding in your urine, or if you often leak urine, you probably have what's called urinary incontinence. Normally, the bladder begins to fill with urine from the kidneys. The bladder stretches to allow more and more urine. You should feel the first urge to urinate when there is about 200 mL, just under 1 cup of urine stored in your bladder. A healthy nervous system will respond to this stretching sensation by letting you know that you have to urinate. But, at the same time, the bladder should keep filling. But the system doesn't work correctly in people with urinary incontinence. Some people with urinary incontinence leak urine during activities like coughing, sneezing, laughing, or exercise. This is called stress incontinence. When you have a sudden, strong need to urinate, but can't make it to the bathroom before you do urinate, it's called urge incontinence. Other people have what's called overflow incontinence, when the bladder cannot empty and they dribble. Urinary incontinence can have many causes, and it's most common in older adults. Women are more likely than men to have it. For some people the bladder muscle is overactive. For others, the muscles holding the urine in are weak. And for others, the problem is sensing when the bladder is full. They might have brain or nerve problems, dementia or other health problems that make it hard to feel and respond to the urge to urinate, or problems with the urinary system itself. To treat urinary incontinence, your doctor can help you form a treatment plan. Most likely, exercises to strengthen the muscles of your pelvic floor will be part of that plan. Bladder training exercises can also be effective. And depending on the cause of incontinence, oral medications, or topical estrogen may be helpful. If you have overflow incontinence and cannot empty your bladder completely, you may need to use a catheter. Your doctor can recommend the best catheter for you. For urine leaks, you might wear absorbent pads or undergarments. Whatever else you try, lifestyle changes may help. Aim for an ideal weight. Losing excess weight and increasing exercise both often improve incontinence, especially in women. Also, some specific beverages and foods might increase leaking in some people. For instance, you might try eliminating alcohol, caffeine, carbonated beverages, even decaf coffee. Drink plenty of water, but do NOT drink anything 2 to 4 hours before going to bed. Be sure to empty your bladder before going to bed to help prevent urine leakage at night. Throughout the day, urinate at set times, even if you do not feel the urge. Schedule yourself every 3 to 4 hours. Urinary incontinence is very common, but many people never talk to their doctor about it. Don't let that be you. See your doctor and bring it up at your next doctor's visit.

Talking to your MD

 

Self Care

 
 

Review Date: 7/4/2022

Reviewed By: Kelly L. Stratton, MD, FACS, Associate Professor, Department of Urology, University of Oklahoma Health Sciences Center, Oklahoma City, OK. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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