More than medication

Taking control

You can start to regain control of your symptoms by making small changes in your daily habits. Don’t rely on avoiding difficult situations or cutting back on your fluid intake – in the long term, these solutions don’t work and simply interfere with your quality of life.

Instead, try the tips in this section to help find what works best for you. And remember – managing the symptoms of bladder problems doesn’t happen overnight. Small steps mean progress. It may help if you set some simple goals that you know you can realistically achieve.

Re-train your bladder

If you have overactive bladder (urge incontinence), your doctor or continence nurse may suggest bladder re-training. The first step is to keep a diary to record the number of times you go to the toilet and the amount of urine you pass each time. Once you know how often you go and how much urine you pass, you can aim to 'hold on' for as long as possible before each time you go to the toilet. It may take several weeks but your ultimate goal is to pass urine up to 8 times in 24 hours.

Tips to train your bladder:

• Try to wait longer between toilet trips. If you go every hour, then try to wait for 1 hour and 15 minutes.
• When you can wait that long without fear of an accident for one or two weeks, try to increase the time further. Try 15 minutes more at first. Then, little by little, wait longer.
• Stick to your timing as much as you can, whether or not you have to go.

When you have a strong urge to urinate:

• Stop what you’re doing and sit down when you can. When you’re still, it’s easier to control your urge.
• Squeeze your pelvic floor muscles quickly several times. These are the muscles that help you hold urine in.
• Relax the rest of your body. Take a few deep breaths to help you let go of your tension.
• Wait until the urge subsides.
• Walk to the toilet. Don’t rush.

Five steps to a firmer pelvic floor

1. First find the muscles that need exercising - they're the ones you use to hold back gas or stop a urine stream.
2. Squeeze the muscles and hold for three seconds. (Women should get a lifting feeling in the area around the vagina. Or you might feel a 'pulling in' of the rectum.)
3. Then completely relax the muscles for a count of three. It's important to control both the tightening and relaxing of the muscle.
4. Do this 10 times at first. If this is very easy, try holding for five seconds. Rest between contractions for the same amount of time.
5. Work up to holding contractions for 6 to 10 seconds. Then rest for 10 seconds before repeating the exercise.

Try to do at least 30 to 50 exercises per day. Exercise in sets of 10 at first. As you get stronger, you can do more sets fewer times a day. Exercising each day is best, but three or four times a week will still help. Find ways to help you remember to do the exercises - some people do them every time they see the colour red, for example - a red bus, red traffic lights, a red coat, and so on.

The more you perform these exercises, the stronger your pelvic floor muscles will get. And the faster you'll improve. Alternate between lying down, sitting, or standing when doing the exercises. This will help you to have more control.

More treatment options

1. Pads provide peace of mind

   The chances are that pelvic floor exercises and medications will put you back in charge of your bladder. But you may need extra help while you’re waiting for treatment to take effect, or just to give you peace of mind. You can buy pads and pants that have been specially designed to absorb leaks from the bladder. Some are disposable, while others can be washed and re-used. There are many varieties available for sale in shops or by mail order. Often women use sanitary pads to mop up leakage as they’re cheaper, but they don’t work as well as the incontinence pads, which draw urine away from the surface of the pad, leaving the skin dry.

2. When the usual methods don’t work

   For a few people with bladder problems, the symptoms are not easily managed. If you’re one of them, don’t give up. Go back and see your doctor as there may be more options to try. In extreme cases of stress urinary incontinence, for instance, your doctor may suggest surgery. There are several different types, including procedures to raise or support the neck of your bladder. Discuss this with your GP or specialist.

Lifestyle dos and don'ts

Do:

• Drink water or herbal teas instead of caffeinated drinks such as tea or coffee.
• Commit to bladder re-training. The aim is to increase the amount of urine the bladder can hold and for you to gain confidence that your bladder can be controlled.
• Make pelvic floor exercises a part of your everyday routine.  No one can see that you're doing them so feel free to exercise in the bus queue or outside the school gates.
• Eat lots of fresh fruit, vegetables and high fibre foods to avoid constipation, which may be putting extra pressure on your bladder.
• Exercise to achieve and maintain a healthy weight and prevent constipation.

Don't:

• Cut down the amount of liquid you drink as this can make bladder problems worse. Aim to drink six to eight glasses of fluid throughout the day.
• Go to the toilet too often, 'just in case', as this can make the symptoms of overactive bladder worse because the bladder gets in the habit of holding less urine.
• Smoke - Smoking can irritate the bladder. Ask your doctor or practice nurse about local stop smoking services.
• Suffer in silence - get help from your healthcare professionals.