DEAR DOCTOR K: I’m a middle-aged woman with urinary incontinence. Is there any way to treat this problem without drugs or surgery?
DEAR READER: Surveys of women across the country indicate that millions have urinary incontinence – the inability to keep from sometimes leaking urine.
There are several strategies you can try before considering medications or surgery.
Start with bladder retraining. This is a program of urinating on schedule. It helps you to gradually increase the amount of urine you can comfortably hold.
To begin bladder retraining, first keep track for a day or two of the times of day you urinate or leak urine. Calculate how long, on average, you wait between bathroom visits during the day, and then add 15 minutes. For example, suppose you calculate that you go to the bathroom about once every hour. Adding 15 minutes brings you to 1 hour and 15 minutes.
When you start training, empty your bladder first thing in the morning and not again until the interval you’ve set – 1 hour and 15 minutes. You may feel uncomfortable as the end of that first hour approaches. However, do your best to hold off urinating until 1 hour and 15 minutes have elapsed. Keep up that practice: Wait another hour and 15 minutes before you urinate again. Each time you do this, you should feel that it is a little easier.
Once you’re comfortable for the whole hour and 15 minutes, then increase the interval by another 15 minutes. Again, it may take a while, but you’ll get comfortable with the longer interval. Once you are, push out the time between urinations again by another 15 minutes. Over time, you should be able to wait much longer.
I also recommend drinking less fluid. For some people, this is all it takes to bring incontinence under control.
Pelvic floor exercises may also help. These exercises, also called Kegels, strengthen the pelvic floor muscles that help maintain continence.