Living with urinary incontinence
Urinary incontinence is a common condition among Australians, and one that can cause significant discomfort and stress. Here’s some helpful tips for living with urinary incontinence.
Urinary incontinence (UI), which entails involuntary urine loss, is a distressing condition that can have a major effect on your quality of life, psychological wellbeing, social functioning and physical health.
In Australia, an estimated 3.84 million men and women have UI, yet up to 70% of people with urinary leakage don't seek advice and treatment for their problem.
Whether you simply leak a few drops when sneezing or laughing, have a sudden urge to urinate but don’t make the toilet in time, or leak most of the time, UI affects people in different ways.
The upside is that there are things you can do to manage UI and regain bladder control. In this way, you can prevent it from making everyday life a misery.
Professor Winsome St John of the Research Centre for Clinical and Community Practice Innovation at Griffith University in Queensland comments that “daily-living management of UI involves creating order, discipline and control – not only to manage the physical consequences of urinary leakage, but also its emotional and social effects”.
While the way people manage UI may vary, the need to control urinary leakage in order to maintain a normal lifestyle remains the underlying theme of daily-living management, according to St John.
A crucial aspect of living with UI is to plan ahead, as this will make things easier and less stressful. Successful planning starts with assessing your specific situation and then working out strategies to deal with the most likely scenarios.
Answering the following questions will enable you to compile a plan for various everyday tasks, including work, shopping, social activities, sport, leisure and exercise, travelling for more than 30 minutes at a time, and sexual intimacy:
• Rate how incontinence affects your life (not at all, slightly, moderately, severely).
• What especially worries you about leaking?
• What have you stopped doing because of UI?
• What do you find most difficult to manage about your condition?
• What aspect of staying dry is most important to you?
• In which situations is it most essential, and around which people?
• When are you most likely to have an accident?
• What makes your leaking worse?
• Which times of the day are more problematic?
• What is it about having UI that you have to manage in order to live your life as you’d like to?
• What are your current UI management strategies and how effective are they?
Tips to cope better
While you're treating UI, there are many simple tips that can help you cope better in various situations at work, socialising or doing physical activity:
• Schedule times to go to the toilet about every two to three hours. This technique, called timed voiding, is important as it helps to keep the bladder empty. Don’t wait until your bladder feels full.
• When you intend to leave home or work, use the toilet, even if you don’t think you need to. Go immediately before leaving home, on arriving and before travelling in a car/bus in order to prevent accidents.
• When you're in the bathroom, take your time. When you've finished urinating, relax for a while and then urinate again. Double voiding ensures you empty your bladder completely.
• Watch what you drink. Some fluids may worsen UI. Reduce or cut out caffeine-rich beverages like coffee, tea and carbonated drinks. Also avoid acidic drinks, sugar-laden cordial with preservatives and cut down your alcohol intake. It is, however, important to keep well hydrated, so try to drink water throughout the day.
• If you've noticed that certain foods make UI worse, cut them out of your diet, if possible.
• Ditch the extra weight. There's a strong link between obesity and incontinence because it increases pressure on the abdomen and pushes down on the bladder. If you're overweight, follow a sensible eating and exercise plan to lose weight. Research has found that obese women who lose just 10% of their body mass can reduce the risk of incontinence episodes by 50%.
• Quit smoking. With some studies showing that smokers have more frequent and severe urine leaks, it might be yet another good reason to stop smoking. This is especially true if you tend to cough during smoking, as it may exacerbate leakage.
• Toilet alert. When out shopping, visiting a gallery or restaurant, find out where the public toilets are located when you arrive. This is especially important if you're going to an unfamiliar public area.
• UI can be extremely embarrassing as you may leak during sex. If you feel too shy to discuss the issue with your partner, reduce fluid intake to minimise leakage, empty your bladder right before intercourse and try out different positions, as you may find that certain ones will minimise leaking.
• Avoid odour by practising strict hygiene, washing frequently, regularly changing pads and using a deodoriser. Also remember to regularly wash soiled clothing and underwear.
• Always make sure you have back-up supplies whenever you go out. These could include spare pads and underclothes, pants, pre-moistened towelettes, deodorised bags, pants, deodoriser, and a plastic bag to dispose of pads, soiled underwear or clothing.
Planning ahead and being prepared can ensure that you enjoy social activities and outings. Here are some tips:
• If you're going to a show or movie with friends, always try to sit on the edge of the row of seats, not in the middle, so that you can get out easily if you need to go to the toilet.
• Go to the toilet before the show or movie starts.
• Manage urine leakage by wearing disposable pads and keeping extra ones in your handbag.
• When eating out in a restaurant, try to get a table near the toilets, and choose a seat that makes it easy for you to move in and out.
Coping at work
• Limit coffee breaks. Avoid drinking coffee several times a day, as caffeine-rich beverages may make you urinate more. Also remember to time your beverage breaks, and don’t swig a cup of tea or coffee just before going into an important meeting.
• Prompt your toilet visits. Set an alarm to remind you to go to the toilet every 90 minutes or every two hours, whether you feel the urge or not. Timed urination helps you to have better control, instead of letting urges determine your toilet habits.
• Remember your medication. If your doctor has given you medication for UI, take it as prescribed, keep some at work and set a reminder if necessary so that you don’t forget to take it when you’re busy.
• Have a supply of incontinence products. Find out about the various incontinence products such as absorbent pads or disposable underwear, odour-eliminating products and pre-moistened non-alcoholic wipes that you can store in a desk drawer or cupboard.
Don’t let UI dominate your life. If you've always been active and enjoy exercise, don’t stop completely – even if it results in leakage.
• Work out which exercises make you leak more and try to modify or swop them with others that
won’t. For example, instead of jogging, you could walk, or instead of doing a strenuous cardio workout, you could try aqua aerobics.
• You may find that you can do an exercise activity for a certain period of time before you start leaking.
• Go to the toilet before you start exercising.
• Consider wearing a more absorbent continence pad during exercise. If you only leak when coughing, sneezing or exercising, you may try using a tampon, as it supports the front wall of the vagina and puts some pressure on the urethra, which can help to minimise leakage.
1. Australian Department of Health and Ageing: Patient information guide - Live Better with urinaryincontinence
2. Craig Comiter, MD, associate professor of urology, Stanford University School of Medicine.American Urological Association: "Minimally Invasive Management of Urinary Incontinence."
3. Prof Winsome St John et al. Daily-living management of urinary incontinence: A synthesis of the literature. Research Centre for Clinical and Community Practice Innovation, Griffith University, Queensland Australia