Written By Bryn Zolty, PT
Do you know where every bathroom is when you leave the house?
Do you pee more often than your friends and family?
Do you ever leak urine on the way to the bathroom?
These are symptoms that can occur when someone has urinary urgency/frequency and/or urge incontinence.
- Urinating more often than 5-8x/day is urinary frequency
- Urinary urgency is a strong, sudden urge to urinate
- Despite the strong urge, it can be a small amount of urine
- Leaking urine with a strong urge, usually on the way to the bathroom is urge incontinence
People dealing with these symptoms will limit water intake, avoid social situations, and go to the bathroom ‘just in case’ throughout the day. However, despite how overwhelming the symptoms may seem, bladder retraining is an effective way to pee less frequently and stop leaking.
You start with a bladder diary. Some things to include are bladder fluid intake, when you urinate, strength of the urge, how much you urinate, and if there were any leaks.
| Time of Day | Type & Amount of Food/Fluid Intake | Amount Urinated (# of seconds) | Amount of Leakage | Activity Causing Leakage | Was Urge Present? (mild/mod/strong) |
| 6:00AM | 15s | small | walking to bathroom | strong | |
| 7:00AM | 8 oz. water & bagel | 5s | strong | ||
| 8:00AM | |||||
| 9:00AM | 12 oz. of coffee | 8s | medium | walking to bathroom | strong |
| 10:00AM | 12s | moderate | |||
| 11:00AM | |||||
| 12:00PM | 6 oz. of water/sandwich & chips | 4s | small | with urge to pee | moderate |
By looking at the time between trips to the bathroom, we figure out how often you are urinating and determine the usual shortest interval that you could go without leaking urine. Looking at this diary, there were 1 hour and 2 hour intervals. Leaking occurred when the interval was 2 hours. The shortest usual interval was 1 hour that no leaking occurred. Therefore, this is where this person would start, going to pee about every hour.
If you are successful, then you add 15 to 30 minutes to your interval. For this diary, that would be a goal of 1 hour and 15 minutes to 1 hour 30 minutes. Once again, if you can make the new interval and not leak with an urge for several days, increase again by 15 to 30 minutes. This continues until you reach 3 hours or a comfortable amount of time for you. An expectation of 6 to 12 weeks to reach your goals is average.
Other tips and tricks for stopping leaks and urinating less often:
- Avoid peeing ‘just in case’; this trains the bladder to empty when it is not full.
- Do not limit water.
- Avoid caffeine and alcohol.
- Sit and breathe calmly when you get an urge.
- Perform 10 quick kegels when you have the urge to pee.
- When you do walk to the bathroom, walk slowly.
- Sit for at least a minute to empty.
- Manage constipation.
A pelvic therapist can help you with a bladder diary and guide you through bladder retraining. In addition, being able to perform a kegel can be an important part of your program, and a therapist can make sure your kegel is effective. Together, we can quickly get your life revolving away from your bladder!
Women's Health in Physical Therapy. Jean and Glenn Irion. Wolters Kluwer Health/Lippincott Williams & Wilkins, Philadelphia, ©2010
Evidence-Based Physical Therapy for the Pelvic Floor. Kari Bo. Elsevier. 2015
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