All forms of incontinence pose social and hygienic difficulties and often take control of our lives. There are effective means by which we can look after ourselves and put ourselves back in control.

Make life easier for yourself

There are simple ways to help yourself cope with incontinence whilst treatment is being sought:

The majority of bladder problems can be relieved and improved through pelvic-floor exercises and supplementary control methods such as electrotherapy, bladder retraining and biofeedback.  You should receive initial guidance from your GP, physiotherapist, or nurse.

Pelvic-floor exercises

Pelvic-floor exercises are suitable for both men and women.  They improve muscle tone, which assists with regaining normal bladder function.  This, in turn, helps recover control over urination.

They help improve self-esteem and a degree of purpose as, after guidance, you take control of the treatment.  Here we have a means of starting to bring back the active, full lifestyle that can easily be lost through the problems that come with incontinence.

Pelvic-floor exercises, in some cases, may be all that is needed. See the Pelvic-floor exercises section for more information.

Electrotherapy

Electrotherapy is sometimes used to increase resting muscle tone.  It can provide a learning technique for the pelvic-floor exercises by helping to identify the feeling that muscle contraction creates.

The technique involves passing an electric current to the muscles around the bladder by means of a small vaginal or anal probe, felt as a tingling sensation.  The stimulation of the nerves sends the message to exercise and tone the muscles, making pelvic-floor exercises easier to repeat voluntarily, taking control of the bladder movements.

Home use should still be supervised after initial guidance from a specialist.

Bladder retraining

Bladder retraining involves keeping a diary for 3 days initially to record the usual pattern of urination i.e. chart of volume and time, and when incontinence occurs.  The aim is to reduce the frequency of urination by stretching the bladder and making it less irritable at appropriate times.  This can prevent the bladder from being so sensitive.

This activity is carried out by gradually increasing the time between visits to the toilet.  This may sound simple, but does require explanation by the GP or nurse.

It is often used in conjunction with another treatment, as the diary can be used to detect any progress or deterioration while condition is treated.  It provides encouragement to continue or, conversely, acts as an indicator that things are not improving, which should be discussed with your GP.

Biofeedback

Biofeedback needs to be initiated by your GP.  The technique measures unconscious body activities such as muscle tension and brain activity.  Through the changing signals from the recording instrument you receive information as to when the level of activity, such as pelvic-floor muscle or brain action, is altering.  This is known as feedback.

After experience of the technique, you become aware of how you feel whenever there is a visual change on the instrument.  This leads to learning how to change the signal, by consciously controlling bladder function through pelvic-floor muscles.  Once this skill has been acquired, this control can be exercised without the use of the instrument.

Self-catheterization

Self-catheterization is a method of self-management for more severe cases of incontinence, after thorough guidance has been sought from your physiotherapist or nurse. 

The method enables emptying of the bladder, around 4-5 times a day, through thin tubes which are held in place by a small balloon attached to a drainage bag. The tubes do not have to be in place all of the time. For further information, look at the section related to Catheters.

Diet and exercise

Healthy diet and exercise help prevent and manage the occurrence of incontinence.

• Maintain a healthy weight
  This involves weight loss for those of us carrying excess weight, and maintaining a healthy weight thereafter.  Being overweight places stress on and weakens the pelvic-floor muscles.
  
• Regular exercise
  Exercise maintains a healthy weight as well as strengthening the pelvic-floor muscles.
  
• Avoid constipation
  Constipation is a contributory factor to incontinence as it puts stresses on the pelvic-floor muscles.  A fibre-rich diet can help reduce the likelihood of constipation; fibre is provided mainly by cereals, especially wholegrain, wholemeal bread, oats, pulses, fruits and vegetables.
  
• Ensure an adequate fluid intake
  An adequate water intake of 6 glasses per day (1-1.5 litres per day) is essential.  Fluid intake helps maintain urine flow and thereby prevents urinary infection developing, which can initiate incontinence.  The fluids required are best provided by water and fruit juices, not fizzy drinks - which have the opposite effect of irritating the bladder.
  
• Steer clear of diuretics
  Diuretic products i.e. those that increase urine excretion, should be avoided. Common diuretics include coffee, tea, and alcohol.
  
• Stop smoking
  Smoking causes chronic coughing that will put a strain on the pelvic muscles.
  

20/05/2009