Khashayar Shakiba, MD, FACOG, FPMRS
Lifestyle and Behavioral Changes 2017-09-06T20:08:27+00:00

Improving Urinary Urgency, Frequency and Urge Incontinence

Manage your Fluid Intake

There is no scientific evidence that states we need eight 8 oz. glasses (64 oz.) of fluid every day. Remember, what goes in must come out! Many women, unless you exercise heavily or work in hot conditions can drink less than 64 oz. per day. In 2004, the Institutes of Medicine reported that most people meet their daily hydration needs by letting their thirst be their guide. You must also remember that we get additional fluids from our diets in the form of soups, stews, fruits, etc. It has been shown that we get as much as 20% of our daily fluids from our diet. If you are used to drinking large amounts of fluids every day and you are bothered by how frequently you need to go to the bathroom, these suggestions may help you:

Don’t carry a water bottle or large container of fluid around with you
Use a smaller glass or cup
Take small sips of fluids instead of large gulp
If your mouth is dry, try sugar free gum or candy

Try spreading out fluids during the day instead of drinking large amounts at one time. This is especially important before leaving the house. If you get up to void more than 2 times per night, you should limit your drinking after dinner.

Avoid Fluids that can be Bladder Irritants

Some chemicals in our beverages can behave as diuretics and bladder irritants. If you are sensitive to these chemicals, they may cause you to make large amounts of urine or may aggravate bladder spasms resulting in a more frequent need to urinate. Some common bladder irritants include:

Caffeine – Try to stop or at least reduce your caffeinated beverages like coffee, tea, and cola to see if your bladder control improves. If you drink a lot of caffeine, you should taper down slowly to avoid a caffeine withdrawal headache.
Artificial Sweeteners – Beverages that contain artificial sweeteners like aspartame or saccharin can also be a bladder irritant. Diet Pepsi, Mountain Dew or Coke then would be especially problematic because of the artificial sweetener and the caffeine.
Citrus juices – Some people find that juices like orange or grapefruit juice can also irritate their bladder. Although there are no scientific studies to prove this, the best thing to do is to stop the suspected irritant for a week or two and see if it makes a difference.
Weight Loss – Being overweight puts extra pressure on your bladder. Weight loss will relieve some of that pressure and will help you regain your bladder control.

Void on a Schedule

Sometimes, the message that the bladder is full comes without warning and often too late. In these cases, women find that they lose urine on the way to the bathroom. There isn’t enough time between the message and their ability to get to the bathroom before they start to leak. Voiding on a schedule, also referred to as “Timed Voids” may help prevent these leaking episodes. It is exactly what it sounds like. You urinate on a schedule, sometimes even when you don’t feel like you have to so that you are not caught off guard. Completing a Bladder diary helps to determine when you usually leak and what is a reasonable period of time between trips to the bathroom.
Slowly, you can stretch the time between trip to the bathroom until you are voiding every 3 or 4 hours. Often times women find that keeping a bladder diary helps them be more consistent with their schedule. Your doctor or health care clinician can help you determine your best schedule if you are having a difficult time figuring it out.

Strengthen your Pelvic Floor Muscles with Kegel Exercise

Most bladder control problems are caused by weak pelvic muscles. These pelvic floor muscles attach to the bones of the pelvis in a way that creates a trampoline of support for the pelvic organs. These muscles help prevent urine leakage. Pregnancy, childbirth, increasing age all weaken the muscles of the pelvic floor. Exercising the pelvic floor muscles can strengthen the pelvic muscles and improve bladder control. Identifying the correct muscles to exercise is important. These are the same muscles you would use to hold back gas or to stop the flow of urine midstream. Your doctor or nurse can help make sure that you are contracting the right muscles. Once you have correctly identified the muscles, you contract and hold the squeeze for a few seconds and then completely relax the muscles before the next squeeze. For more detailed instruction on how to perform pelvic muscle exercises, visit Expect that it will take about 6 to 8 weeks of exercising before you notice that you have fewer leaks and more bladder control.

Urge Suppression Strategies – “Freeze and Squeeze”

If you have trouble reaching the bathroom before you start losing urine, we recommend trying this technique. When you get the urge to urinate:

Stop and stay still, sit down if you can
Squeeze your pelvic floor muscles quickly 3 to 5 times; repeat as needed
Relax the rest of your body and take a deep breath
Concentrate on suppressing the urge
Distract yourself to get your mind on something else
Wait until the urge subsides, then walk to the bathroom at a normal pace
Don’t ignore the message

Bladder Training

Once you have mastered the Urge Suppression technique, you can now train your bladder to increase the time between the initial urge and the time you actually void. Simply follow the Urge Suppression technique, but nstead of walking calmly to the bathroom at your normal pace, you will wait a few minutes before voiding. At first you may only be able to postpone voiding by 1 minute, but keep trying to increase the interval between the initial urge and the time you actually void until you are only voiding every 3 to 4 hours. Like any new technique, this takes practice and time to master, so we recommend trying this at home initially until you become more successful.