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Baylor Scott & White Texas Urogynecology Associates

Is it time for you to take the next step?

 

Bladder control issues are not a normal part of aging and they are not something you should have to live with. If you answer "yes" to one or more of these questions, consider talking to your physician today about your symptoms and available treatment options.

  • Are you using the bathroom so often it disrupts your day?
  • Do you find yourself making a mental note of where all the bathrooms are when you enter the building?
  • Do you find it hard to make it to the bathroom, maybe even having an accident sometimes?
  • Are you using pads or other forms of protection to absorb bladder leakage?
  • Are you worried that you will leak while sneezing, coughing, lifting heavy objects or even laughing?
  • Have tampons become too uncomfortable to use or do they fall out?
  • Are you experiencing pressure or bulging in your vagina, especially after standing for long periods?
  • Has your urine stream become weak or turned into a spray?

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 are especially problematic because they contain artificial sweetener and caffeine.
  • Citrus juice - 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.
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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 percent 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 around with you
  • - Use a smaller glass or cup
  • - Take small sips of fluids instead of large gulps
  • - If your mouth is dry, try sugar-free gum or candy

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

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Begin a Kegel exercise routine

 
 

Pelvic muscle exercises (Kegel) are used to strengthen or retrain the nerves and muscles of the pelvic floor. Regular daily exercising of the pelvic muscles can improve and even prevent urinary incontinence. It is recommended that you do 4 to 8 sets of 10 squeezes over the course of each day. You may have to keep at it for several weeks before you may notice any difference. Over a period of time, your pelvic muscles will strengthen and your symptoms of urgency or frequency may decrease.

How to perform Kegal exercises

  • Try to stop your urinary stream.  If you succeed then you have identified the right muscles to exercise.  This is a learning tool.  Do not stop your urine frequently as there is concern that this may create problems with emptying your bladder.
  • Imagine you are going to pass gas, then, squeeze the muscles that would prevent that gas from escaping from your rectum.  Exercising the muscles around the rectum will also strengthen those around the vagina and under the bladder.
  • Use a hand mirror to look at your vaginal opening and the perineum (the muscle wall between the vagina and rectum).  You should see the perineum lift up when you contract your pelvic muscles.
  • While lying or sitting, place one finger inside your vagina.  Squeeze as if you were trying to stop urine from coming out.  You should feel your finger lifted and squeezed if you are correctly contracting your pelvic muscles.
  • Do not hold your breath while exercising.
  • Remember not to tighten your stomach and back muscles or squeeze your legs together.  These should be relaxed as you isolate and contract just your pelvic muscles.

Recommended Kegel exercise routine

  • Start by pulling in and holding a pelvic muscle squeeze for 3 seconds then relax for 3 seconds.
  • Do this for 10 repetitions three times a day.
  • Increase your contraction hold by 1 second each week until you are contracting for a 10 second squeeze.
  • Remember to rest and breathe between contractions.

When you start, do the exercises while lying down.  As you get stronger, do an exercise set sitting and standing.

Start the conversation with your doctor

 

​It can be difficult to talk about problems such as incontinence or vaginal bulges, even with a doctor. But doctors are used to talking about these problems, and it is worth asking about your symptoms because they can most likely be treated. Here are some things you should tell your doctor to get the conversation started.

  • My last pelvic exam was ___ (days, weeks, months, years) ago
  • I have___ child(ren) and delivered___ (vaginally/by c-section)
  • I'm having some or all of the following symptoms:
    • Pain, pressure or a bulge "down there"
    • Trouble urinating or passing a bowel movement
    • "Leaking or needing to use the bathroom often
    • Pain during urination
  • My symptoms started ___ (days, weeks, months, years) ago
  • I have these symptoms ___(daily, a few times a week, monthly)
  • I want to find ways to treat or cure these symptoms
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