Treatments
There are many treatment options available, speak to your GP or continence advisor for further information. Below are many of the options available:
Urinalysis and culture
It may be considered necessary to provide a sample of urine for testing to ensure that there is no infection or blood present.
Bladder diary
You may be asked to record when you pass urine and how much, over a short period of time and include how much fluid you are drinking.
For urge incontinence or overactive bladder it may help to complete a bladder diary for 3 – 5 days to show how often you go to the toilet and how much (volume) urine is passed each time. This will help your health care practitioner understand your symptoms.
Take your completed diary with you when you see your GP or continence advisor. It may provide them with useful information to help with diagnosis.
Internal examination
You may be asked to undergo a physical examination by your GP.
Urodynamics
A test to measure the pressure and sensitivity of the bladder as it is filling.
Videocystourethography
Flow pressure study combined with X-ray screening.
Uroflowmetry
This measures the rate at which urine is passed per second. This can show if there is any obstruction to the flow or any difficulties in passing urine.
Residual Urine Test
This is a non-invasive test using a bladder scanner to determine if urine is left behind in the bladder after going to the toilet.
Cystoscopy
This is an examination looking into bladder with a camera to locate any abnormalities. It is often done under a general anaesthetic but may be done under a local.
Incontinence is a symptom rather than a disease in itself. The treatment therefore is dependent on the type of incontinence diagnosed. For some, a change in diet or the elimination of certain medications can be beneficial and can even lead to the sufferer being cured.
There are four main categories of treatment available, diet, bladder control training, pelvic floor exercises and medication.
Diet
Fluids – A sufficient amount of fluid should be drunk on a daily basis (between 1.5 and 2 litres per day) to ensure that urine does not become overly concentrated and irritate the bladder. Too little fluid can put the bladder at risk of infection and too much fluid will cause urinary frequency. If necessary, fluid intake may be restricted during the evening to lessen night-time frequency.
It is important to avoid drinks containing caffeine, alcohol and carbonated drinks as these will irritate the bladder.
Foods – Acidic foods should be avoided as these may irritate the bladder. Chocolate – milk and dark, should be avoided as they contain caffeine, although white chocolate should be well tolerated.
Bladder Control Training
Bladder control training is a course of treatment designed to help improve bladder weakness. It involves urinating only when scheduled at progressively increasing intervals. While undergoing bladder control training it may be useful to keep a bladder diary detailing fluid intake, voiding and amount of leakage. You will find an example of this at the back of this booklet.
In combination with biofeedback and pelvic floor exercises, the method can be useful in helping to control urge incontinence.
Pelvic Floor Exercises
These are simple exercises to strengthen or retrain weak pelvic floor muscles.
The exercises are usually taught by a women’s physiotherapist or continence nurse and involve repeated contractions of the pelvic floor muscles. The muscles can be weakened by some surgery, constipation, heavy lifting, chronic cough, being overweight, lack of general fitness, pregnancy or childbirth and changes in hormone levels during the menopause.
Medication – see list of medications available on next page.