A first-line approach for any form of incontinence can be a combination of Kegel exercises and bladder training. Weak pelvic muscles can cause you to leak urine. When these muscles get weak, you can help make them strong again. You can regain control through pelvic muscle exercises, also called Kegel exercises and by bladder training.

What are Kegel exercises?
Kegel exercises involve the voluntary contraction and relaxation of the pelvic floor muscles. Kegel exercises strengthen the muscles that support the urethra, bladder, uterus, and rectum.

How will Kegel exercises help?
Weak pelvic floor muscles contribute to urine incontinence (leakage). Doing Kegel exercises correctly and regularly will reduce or eliminate urine leakage and may prevent the need for surgery. Doing the exercise is risk-free, painless and free!

The Kegel exercise is simple and can be done anywhere, anytime. The objective is to strengthen the muscles that control urine flow.

Be patient and continue to exercise. It takes time to strengthen the pelvic muscles, just like it takes time to improve the muscles in your arms, legs or abdomen. You may not notice any change in bladder control until after 6 to 12 weeks of daily exercises.

~Where are these muscles? You can find them easily by urinating and stopping the flow midstream.

~Practice squeezing these muscles when you are not urinating. Hint: If your stomach or buttocks move, you're not using the right muscle group.

~ Hold the squeeze for 3 seconds, and then relax for 3 seconds.

~Repeat the exercise 10 to 15 times per session.

~Complete at least 3 sets (30-45 squeeze/relaxes) every day. This is the minimum. Many women need to do a total of l00 squeeze/relaxes a day for complete control to occur.

~An alternate form is to gradually tighten the muscles a bit, hold for the count of five, gradually tighten them a bit more and hold for five again and then tighten as much as you can and hold for five. Reverse, loosening a bit and holding X three until the muscles are totally relaxed. Repeat tightening and loosening for 5 sets.

To attain and keep control, you must do these pelvic floor Kegels every day. If you forget, your bladder will remind you!

What is Bladder training?
Your doctor may ask you to keep a bladder diary—a record of your fluid intake, trips to the bathroom, and episodes of urine leakage.

How will bladder training help?
This record may indicate a pattern and suggest ways to avoid accidents by making a point of using the bathroom at certain times of the day—a practice called timed voiding. As you gain control, you can extend the time between trips to the bathroom. Bladder training also includes muscle exercises to strengthen the muscles that hold in urine.

~ Keep a bladder diary to record how much and how often you urinate during a 24-hour period

~ Keep track of the number of urine leaks you have each day; as you continue with bladder training, compare your leaks to chart your progress

~Practice putting off urination after you feel the urge to go; start by trying to hold your urine for 5 minutes every time you feel an urge to urinate. When it is easy to wait 5 minutes to urinate, try to increase the waiting period to 10 minutes. Gradually lengthen the waiting period until you're urinating every 3 to 4 hours.

~When you feel the urge to urinate before your time is up, it may be helpful for you to practice relaxation techniques. Breathe slowly and deeply. Concentrate on your breathing until the urge goes away. Doing Kegel exercises (contracting the muscles that stop your urine flow) may also help you control urges.

~ Learn to control your incontinence by going to the bathroom on a schedule; plan times to go to the bathroom, whether you feel the urge to urinate or not; you might start by going to the bathroom every hour, then gradually increase the time between bathroom trips by 30 minutes until you find a schedule that works for you.

~Limit how much your drink before bedtime helps reduce nighttime incontinence.

~ Avoid being discouraged; bladder training often takes 3 to 12 weeks

Summary

Weak pelvic muscles often lead to urine leakage. Daily exercises can strengthen pelvic muscles. These exercises often improve bladder control. Ask your doctor or nurse if you are squeezing the right muscles. Tighten your pelvic muscle before sneezing, lifting or jumping. This can prevent pelvic muscle damage and urine leakage. Bladder training record may indicate a pattern and suggest ways to avoid accidents

This information is for informational purpose only, and is not intended to replace the advice or care of your doctor.