What You Can Do to Remedy Urinary Incontinence

November 26, 2024

Sick middle aged man with cystitis from frequent urinary retention

Many people feel embarrassed when they accidentally leak urine, but we’re here to tell you that you’re not alone.

“Urinary incontinence is ‘normal,’ in that it can happen to anyone,” says Unwanaobong Nseyo, M.D., M.H.S., urogynecologist and assistant professor of urology at Weill Cornell Medicine. Thankfully, “there are options for managing your incontinence, no matter how much or how little there is. The decision to do something about your incontinence is really determined by how much it bothers you.”

Understand Your Incontinence

According to the National Library of Medicine, smoking, birth defects, obesity and aging all increase your risk for urinary incontinence. Types and causes of incontinence include:

Urinary leakage at night. Children who wet the bed after age seven may have an underlying health issue, slow development or another issue. Urinary tract infection, enlarged prostate and other conditions can cause adults to experience incontinence. Other causes include caffeine, alcohol and certain medications.
Overflow incontinence. Tumors, diabetes, an enlarged prostate and some medications can prevent your bladder from emptying. When this happens, your bladder may leak urine when it becomes too full and overflows with urine.
Stress incontinence. If your bladder is out of place or your pelvic floor muscles are weak, stress or increased pressure on your bladder can cause leakage of urine. Leak-inducing activities may be as minor as a cough, sneeze or laugh.
Urge incontinence. Sometimes, you may feel a frequent strong need to urinate and not always make it to the restroom in time. This is called urge incontinence. This type of incontinence can be connected to various health conditions, including overactive bladder, urinary tract infections and neurologic conditions such as multiple sclerosis. Though it may occur at any age, it’s most common in older adults.

Sometimes, you get more than one type of incontinence. This is known as mixed incontinence.

DIY Incontinence Care

The first step toward managing incontinence often takes place in your home. In fact, the right self-care may be all you need to regain control of your bladder. Start with these lifestyle changes:

Avoid bladder irritants such as coffee, sodas and spicy foods.
When you urinate, make sure you are comfortable and relaxed, giving yourself time to empty your bladder all the way.
Minimize constipation.
Get plenty of exercise.
Obtain and maintain a healthy weight.
Stop smoking or don’t start.

Additionally, you may benefit from bladder control-specific steps, such as:

Exercising your pelvic floor. Kegel exercises strengthen your pelvic floor and help reduce leakage. To perform Kegels, tighten the muscles in your pelvis that stop urine flow. You can learn how to perform Kegels by practicing the exercise while urinating—try to stop your urinary stream or stop yourself from urinating. Hold for three to five seconds, relax and repeat. Perform 15 repetitions, three times a day. This exercise is helpful for women and men with incontinence alike.
Scheduling bathroom breaks. Bladder training starts with tracking your fluid intake and bathroom habits. You then create a urinating schedule that you follow carefully. As you gain control over your bladder, you adjust your schedule to go longer periods between bathroom breaks.

If your child wets the bed, help them to avoid drinking fluids or eating fruit, popsicles or ice cream two hours before bedtime.

“We always recommend that a child pee, brush their teeth and do what they normally do before bed,” says Denise Galan, pediatric nurse practitioner in the Department of Urology at Weill Cornell Medicine. “And right when the child is ready to sleep, they should try to pee one last time.”

The same advice applies to adults who have issues with urine leakage at night. They should try to limit fluid intake within two to three hours of when they typically go to bed. A small sip of water with medications is okay.

Specialty Care for Improved Bladder Control

If at-home treatments don’t correct your leakage issue, work with your medical provider to find an approach that works for you.

“For more than a decade, we’ve seen a wave of innovative treatments for urinary incontinence,” says Richard Lee, M.D., M.B.A., associate attending urologist and associate professor of urology at Weill Cornell Medicine. “With so many effective approaches, there’s simply no reason to avoid seeing a urologist.”

Nonsurgical Treatment Options

Your provider may recommend one or more conservative treatments to help improve your incontinence symptoms. Treatment options that may help outside of the operating room include:

Intravaginal support device. A diaphragm-like device called a pessary can help women. Inserted in the vagina, the pessary supports the urethra, making leakage less likely.
Catheterization. Men and women who experience incontinence may benefit from an internal or external catheter (thin, flexible tube), which helps empty the bladder.
Medication. The type of medication depends on the underlying cause of the urinary leakage. Some medication helps relax the bladder. There’s even medication to shrink an enlarged prostate in men.
Nerve stimulation. Devices are used to communicate with a nerve near the ankle that then communicates with the bladder to help bladder symptoms. With these devices, small electrical impulses help retrain your bladder reflexes to function at the proper time. There is also an option for a surgical nerve stimulation procedure, called sacral neuromodulation.
Physical therapy. A physical therapist creates a treatment plan tailored to your specific needs. The physical therapist’s goal is often to strengthen your pelvic floor so you find relief from incontinence, but ultimately it depends on your particular pelvic floor issues.

Surgical Care for Urinary Incontinence

In some cases, surgery is necessary. For the right patient, surgery provides a long-lasting solution to urinary incontinence. Surgical options include:

Increasing the size of the bladder. Bladder enlargement surgery uses your intestines to increase the size of your bladder, allowing your bladder to hold more urine, reducing your need to urinate. However, the surgery may make it more difficult to empty your bladder on your own. If so, your provider may prescribe a catheter after surgery. This surgery is more often done when there is a nerve-related or neurologic problem with your bladder or when no other treatments have worked.
Injections. A provider can inject a treatment to help close the bladder. With a more tightly closed bladder, there is less urine leakage. A minimally invasive option, bladder Botox injections can also be used to treat incontinence or overactive bladder.
Removing or shrinking the blockage. When something blocks the urethra and prevents the bladder from emptying, removing the blockage can bring relief. “The most striking advancements we’ve seen,” Dr. Lee says, “have been in the area of surgery to reduce the size of the prostate.” Today, several new approaches help men experiencing incontinence due to an enlarged prostate. At Weill Cornell Medicine, laser technology, steam, high-pressure water and more help shrink the prostate.
Placement of a sling. A surgeon places synthetic mesh under the urethra, holding the urethra in place and preventing leakage. This is typically used for women with stress incontinence but can help men as well, according to the National Institute of Diabetes and Digestive and Kidney Diseases.