• Bladder and Pelvic Health
• Uniquely Female

How to Keep Going When You “Gotta Go”

You’re busy with family, work, travel, fun. Don’t curtail the life you love because you’re embarrassed or afraid you won’t be able to control urine leakage. Whether at the office, working out at the gym or on the road, you can control or even eliminate symptoms by making changes in your lifestyle and behavior.

Female Pelvic Medicine and Reconstructive Surgeon Jerome Yaklic, MD, OB/GYN, Wright State Physicians Obstetrics & Gynecology, talks about the relationship between urinary incontinence and quality of life.

Click play to watch the video or read video transcript.

What helps:

• Drop the extra weight: If you are overweight, losing as little as 5 to 10% of your total body weight can cut your incontinence episodes in half. That’s because you put less stress on your pelvic floor when you are at a healthy weight.
• Control your fluid intake: How much fluid you should drink depends on your symptoms. For urinary incontinence, cutting back can mean fewer trips to the bathroom. However, if you are constipated, more fluids are typically recommended.
• Watch your diet: Cut down on bladder irritants like caffeine, which is found in coffee, tea, chocolate, cola, energy drinks and artificial sweeteners. These foods can cause bladder muscle spasms, triggering a sudden need to urinate. Fortify your diet with fiber to avoid constipation. If needed, use a stool softener.
• Fine-tune your physical activity: Being active helps you maintain your weight and keeps bowel movements regular. Ask your doctor about high-intensity workouts, which can put excessive pressure on your pelvic floor.
• Don’t smoke: The risk for pelvic floor disorders doubles for women who smoke.

Also consider:

• Pelvic floor muscle exercises (Kegels): Repeated studies show that learning how to control and strengthen the pelvic floor muscles can help reduce or even eliminate urine leakage. If you have mild to moderate symptoms, check out these exercises.

Dr. Yaklic explains the importance of Kegels, pelvic muscles that aid bladder control.

Click play to watch the video or read video transcript.

What are kegels and why are they important?

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Kegel exercises are pelvic strengthening routine. So, if I had a situation where I told you I wanted to build up your bicep muscles, you know, you would go home and you would exercise in that muscle. If we wanted to improve the strength in the pelvic floor we do Kegel exercises, exercises direct to the muscles that help to control that urine and better to flow in the pelvic floor. The problem that we often face with Kegel exercises everybody kind of says, oh yeah you just go home and you kind of those muscles. But oftentimes people do Kegels incorrectly and that’s really where the challenge goes in. We’ll see women that will come in, yeah I have been doing Kegel’s for years, I have been doing Kegel’s for years and they are tightening their butt cheeks and flexing their leg muscles and tightening their stomach muscles and they are never really building up the muscle that they need to train.

I always tell people exactly that if I said you were going to go home and buildup your muscles and you went home and did leg curls you probably wouldn’t buildup your biceps very well. So, that’s where physical therapy and pubic rehabilitation can really come in.  Very often we can give some basic training in the office for Kegels, but if that’s unsuccessful, it maybe that the person won't respond to Kegels or it may just be that they are really not doing the exercises correctly and going and working with that personal trainer for the pelvis that that physical therapist can be very effective at them gaining those skills.

• Bladder Retraining: Going to the bathroom on a regular schedule – for example, every two-and-a-half to three hours – can help decrease leakage. It may take a few months, but the rewards are worth the investment.

You can control or even eliminate symptoms by making changes in your lifestyle and behavior.

Products to help manage your symptoms with ease:

• Pantiliners: These thin, discreet disposable liners help keep you dry and confident, especially during high-risk activities like exercise.
• Pads: Incontinence pads can be disposable or reusable. Typically, they can hold about eight ounces of urine. An absorbent layer keeps you dry, and the moisture barrier protects furniture and mattresses.
• Briefs: Incontinence briefs look like underwear — some are even lacy and come in different colors. With a waterproof liner and built-in pad, they hold about 10 ounces of fluid.
• Plastic pants: For mild to moderate leaks, consider wearing over your underwear to protect your clothing as well as furniture and mattresses.
• Adult diapers: Generally disposable, they come in a variety of styles, colors and sizes.

Be sure to talk with your doctor for more information on ways to manage urinary incontinence.

Source: Jerome Yaklic, MD, OB/GYN, Female Pelvic Medicine and Reconstructive Surgeon, Wright State Physicians Obstetrics & Gynecology; American Urogynecologic Society