Tips for Improving Urge Urinary Incontinence

Urinary urgency happens when the bladder squeezes when it is not supposed to. This can cause urine leakage or urge urinary incontinence. Urgency can occur for many reasons. Commonly it is due to an overactive bladder or poor urination habits. Physical Therapists specializing in the pelvic floor can teach you ways to retrain your bladder to help with urgency and leakage.

When you have a strong urge to urinate there are several things you can do to calm the bladder. Practicing ways to calm the urge before you go to the toilet will help prevent leaking. It also helps to retrain your bladder so that it does not squeeze when it does not need to.

To calm an urge and begin retraining your bladder, start with the steps outlined below:

• When you have a strong urge to urinate, stop your activity. Avoid rushing to the bathroom. It is more difficult to calm your bladder when you are rushing.
• Take slow breaths and think positive thoughts to help relax and stay calm.
• If you continue to have an urge, do 10 slow heel raises or toe curls. This can help to relax the bladder to calm the urge.
• If you are standing, sitting down might help. The pressure on the pelvic floor helps to calm the urge. Stay still. You will go to the bathroom in a minute once the urge is gone.
• Consider distracting yourself by counting backward, singing a song, or focusing on another task.
• Pelvic floor contractions (Kegels) can inhibit the bladder. This helps the bladder relax and hold urine. If you are able, contract your pelvic floor. Attempt to hold the contraction until the urge subsides. If you are unable to hold the contraction that long, try squeezing and relaxing the muscles several times in a row until the urge subsides.

When the urge subsides, take a deep breath to relax your body. Calmly proceed to the restroom. Avoid unbuttoning your pants or adjusting your clothes before you are ready to sit on the toilet. This sends signals to your brain and bladder that you are ready to void. Doing it too early may cause leakage. If the urge returns, repeat the steps above. This may require you to stop and pause on the way to the bathroom. Do not rush to the toilet, even if it is close by.

Tips to Assist with Treating Urge Incontinence

DURING THE DAY

• Stay hydrated with water. Consider drinking 6-8 cups of water per day.
• Avoid or limit bladder irritants. Bladder irritants include coffee, soda, alcohol, and tobacco.
• Avoid going to the bathroom “just in case.” It is normal to urinate every 2-5 hours or 4-7 times during the day.
• Avoid constipation.

WHILE TOILETING

• Encourage relaxation by breathing into your belly, think open and relaxed, allow the urine to leave. Try not to push or strain to urinate.
• Urination should last at least 8-10 seconds. If you urinate for less than this time, you might be misreading the signal.
• Once on the toilet, do not try to stop the flow of urine. Relax and let it go. Do not do pelvic floor exercises (Kegels) while urinating.

This patient education handout was developed by the Academy of Pelvic Health Physical Therapy (APTA Pelvic Health) and is meant to provide general information, not specific medical advice. It is not intended to substitute for the judgment of a person’s healthcare provider. Additional information can be found at www.aptapelvichealth.org.