involuntary urination, or urination without knowing you have lost urine. The key
to successful treatment of urinary incontinence rests in proper evaluation of
the underlying condition.
If the incontinence is associated with cloudy urine or pain, burning or urgency
in urination, the incontinence may be the result of infection.
If foods are involved in causing the incontinence, or in causing an inflammation
of the bladder called cystitis, this may be the source of the incontinence.
Infection is most frequently associated with a food sensitivity, the irritation
from the food weakening the lining of the bladder which then allows a germ to
infect the bladder.
If the incontinence is brought on by coughing, sneezing, laughing, exercise or
strong emotions such as intense grief, the diagnosis is stress incontinence.
If the incontinence occurs mainly during cold weather, it may be caused by
If the incontinence occurs mainly when you are reaching for the bathroom door or
removing your clothing, it may be due to weak control of the voluntary muscles,
and a strong detrusor muscle in the bladder (involuntary) which squeezes the
bladder while the voluntary muscle control is not at its peak.
If the condition began following surgery or radiation, there may have been nerve
or muscle damage which may be more or less permanent.
It can be helpful to keep a voiding diary recording the times of voiding, the
volume voided, any incontinence episodes, the severity of the leakage, and
whether it occurs at night or on a regular daily schedule at a certain period
during the day. Keep the diary for one week. If your incontinence comes on only
after drinking large quantities of water, some degree of fluid restriction may
be helpful. If the urine volume is 2000 to 3000 cc. per day (two to three
quarts), the diagnosis may be over
Urinalysis and blood tests should be performed to determine if there are
systemic problems such as diabetes, nephritis. If the laboratory test results
show abnormalities in some of the chemistries, this can be the cause of
incontinence. Sugar in the urine or too much calcium can both aggravate
incontinence. When elevated calcium causes mental confusion, this condition can
result in interference with urination.
Hypothyroidism has been associated with irritability and instability of the
If the person becomes chronically dehydrated and has very concentrated urine,
the waste chemicals in the urine can irritate the bladder and cause
with residual urine:
If the urinary bladder is not completely emptied with each urination and there
is a significant "residual urine," this can lead to incontinence.
Nervousness or being in too big a hurry to finish urination can cause residual
drugs change urethral pressure preventing effective bladder emptying, urinary
retention, or challenge the bladder with excessive fluid load--antihypertensives,
antidepressants, antipsychotics, sleeping pills, caffeine, muscle relaxants,
antihistamines, diuretics, hormones (progesterone, thyroid hormones). in one
study over 70 percent of nursing home residents with incontinence took drugs. In
another study it was 90 percent.
or urge incontinence:
Patients who cannot move about very well may not have time to get to the rest
room to prevent an accident.
An examination of the pelvis, or abdomen, may detect masses, suprapubic
fullness, or tenderness.
A pelvic exam should be performed to evaluate the perineal skin for rashes, and
the vagina and urethra for evidence of estrogen deficiency leading to irritation
of the urethra or bladder. Some women respond to treatment with herbs and diet
for low estrogen (about 50 percent of symptoms are relieved).
The urethral diverticulum often gives tenderness in the vaginal wall. Prolapsed
uterus can cause pressure on the bladder resulting in a small capacity for
Muscle function should be tested in the urethra, as well as the perineal
muscles. Check the anus and note the quality of the pressure on the examining
finger which can easily reveal the strength of all perineal muscles including
urethral muscle strength.
Neurologic function should be assessed by perineal sensations, whether pin
pricks appear sharp or blunt. This checks the nerves. S2, S3, S4 evaluates the
strength of the lower limbs by simple actions requiring strength. Gentle
stroking of the perianal region with a pencil eraser will produce the
"wink" reflex from reflex contraction of the perineal muscles.
Drink plenty of water to keep the urine diluted as concentrated urine can
irritate the bladder. The color of the urine must be pale straw colored, or you
are not drinking sufficient water.
Keep the extremities constantly warm. Chilled feet and legs cause a reduction in
blood flow to the pelvic organs, and retard healing of the bladder.
Six times daily for one minute each time, practice contracting to the full
extent of the power of the musculature of the perineum, buttocks, thighs, and
lower abdomen for cutting off an imaginary urinary stream. These exercises
should follow each other as rapidly as is possible to get a full and intense
contraction. Then relax fully before repeating the contraction. At least 20
contractions should be done during the one-minute. This is best done twelve to
fifteen times a day when one is not urinating, and only occasionally when
urinating to test the effectiveness of your efforts.
passing the urine, after urination has been fully established, practice stopping
the urine flow. Then start it up again, and a second time practice stopping the
urine flow totally. Then empty the bladder and press the remaining urine from
the bladder with a straining action.
Kegel exercises for genuine stress incontinence has been shown to be beneficial
in all patients who have tried the exercises. A group of 14 women had supervised
pelvic floor exercises for four weeks and all received benefit. It has been
shown that most women, even though they have benefit from the exercises in a
four-week period, failed to continue the exercises over a long term period. It
appears that motivation for the exercises is fairly low. Reference: Southern
Medical Journal 88(5):547-550 May, 1995
Practice the habit of crossing the legs and squeezing the pelvis together in
order to strengthen voluntary control over the bladder.
Use pads or other protective devices if necessary.
While lying on the back on a carpeted floor, support the entire weight of the
body on the heels and the shoulders by lifting the hips and thighs, head and
arms, off the floor. This exercise should be maintained for three seconds only
on the first day. if no discomfort arises from having done the exercise, the
second day may be advanced from one to three seconds. Continue advancing the
number of seconds daily up to one minute.
While lying face down on a carpeted floor, lift both the lower and the upper
extremities, shoulders and head, off the floor behind your back, supporting the
weight entirely with the abdomen. This exercise should be maintained for three
seconds only on the first day. If no discomfort arises from having done the
exercise, the second day may be advanced from one to three seconds. Continue
advancing the number of seconds daily up to one minute.
Schedule a certain time for passing urine, every hour at first, trying to
abstain from voiding at any other time. After ten days increase the interval
between voidings, the goal being an interval of two and a half to three and a
Knee chest position
- Kneel on the bed or floor, bend over to rest head and arms on the bed. Try to
actually get your chest on the bed. This position allows the organs inside the
abdomen to move toward the head which promotes good circulation and stretches
the muscles of the perineum, encouraging good tone. Hold the knee-chest position
for 1-5 minutes.
Stand, sit, and lie with good posture.
When performing any physical function, whether it be exercising out-of-doors,
chopping vegetables in the kitchen, doing shop work, or sitting at the computer,
good posture should always be maintained. If the head and shoulders are carried
forward during walking, it can lead to neck or shoulder pain. The skeleton
should be entirely balanced, one vertebra held directly perpendicular to the one
below it as much as possible so that the back and neck are in the "neutral
position," the cheek bones directly over the collar bones, and the knees
relaxed, not hyperextended. Mental and emotional benefits, grace and dignity,
self-possession, courage and self-reliance, are all promoted by an erect
bearing. Keep the shoulders back and down, and the head erect.
Practice breathing deeply before sleeping, while sitting at one's desk, working
in the house, or exercising out-of-doors. Every time you go through a door, take
a deep breath. This action soothes and strengthens the abdominal organs and
Many people are sensitive to certain foods or beverages, causing the bladder to
become unusually sensitive. Then upon stress or filling, the bladder gets such a
stimulus to contract that the voluntary muscles are unable to prevent loss of
urine. In order to prevent this sensitivity, one may discover those foods to
which one is sensitive and remove them from the diet. Eliminate the following
list of foods for 28 days, or until the incontinence stops:
Dairy products (causing over 60 per cent of all food
allergies), chocolate, colas, coffee, tea, eggs, pork, beef,
fish, all flesh foods, legumes, peanuts, soybean products,
citrus fruits and juices, tomatoes, potatoes, eggplant,
peppers, corn, cornstarch, corn products, rice, wheat,
oatmeal, yeast, cane sugar, cinnamon, irritating substances,
spices, beer, alcohol, food colors (both artificial and
natural), strawberries, apples, bananas, nuts (all kinds),
seeds, lettuce, garlic, onion.
soon as the 28 days are up, or the incontinence ceases, whichever comes first,
start adding the foods back one at a time every five days until the incontinence
returns. Make a list of all those foods causing the incontinence.
Horsetail or Shavegrass
- 1/4 cup steeped for half an hour
in one quart of boiling water. Use one quart a day for soothing the bladder.
- 1/3 cup to one quart boiling water Remove from heat and steep for 30 minutes
for soothing the bladder.
- One teaspoon of tea in a cup. Pour one cup of boiling water onto the leaves.
Steep for 30 minutes. Drink one to eight cups daily as needed for soothing of
- make and use as you would the buchu.
If you have a urinary tract infection take golden seal and echinacea, one
tablespoon of each boiled gently in one quart of water. May be mixed with
Take one to six cups of catnip tea daily for its soothing effect on the bladder,
along with marshmallow and buchu tea. Put one tablespoon of marshmallow root in
a quart of gently boiling water and simmer 20 minutes. Pour it all up into a
container having one tablespoon of buchu and one tablespoon of catnip. Steep 30
minutes. Strain and drink over the next twelve hours. Make up fresh daily.
A recent report in a medical journal indicates that a cervical diaphragm, such
as is used for contraception, may control stress incontinence in women almost
completely. It will require fitting by your doctor. Cut away the part that fits
over the opening of the cervix, leaving just the ring around the cervix. The
ring will press against the bladder neck and control most leakage. It can be
easily inserted by the person herself. Remove once a week, rinse well in cold
water and reinsert.
For stress the best hope for control is frequent emptying of the bladder and
wearing a protective pad anytime it is expected intense emotions might be felt,
or when you are in the grip of coughs or colds.
Treat other conditions:
Treat appropriately any hormone or metabolic condition such as hypothyroidism or
Take plenty of time to completely empty the bladder with each urination, as the
bladder can "squeeze" itself somewhat, which encourages shedding of
the dead superficial layers of cells much in the same way the skin sheds. Try to
encourage complete emptying by gentle straining and by gentle pressure on the
if a tumor or a cancer is suspected, contact a laboratory to do cytology studies
on freshly voided urine. They will provide a fixative solution for you to
collect the urine in for transport to the lab.
Any drugs being taken, and many nutrient supplements, should be discontinued if
possible to test whether the pill is causing the incontinence.
Return To Counseling Sheets
Disclaimer: The above counseling sheet
is provided courtesy of the Uchee Pines
Health Institute. The Uchee Pines Institute was started almost 30 years ago
by Calvin Thrash, M.D., specialist in Internal Medicine, and his wife, Agatha
Thrash, M.D., board specialist in pathology. It is a non-profit, health
educational and treatment facility located in the country near Seale, Alabama,
15 miles from Columbus, Georgia. (Address: Uchee Pines Institute, 30
Uchee Pines Road
Seale, Alabama 36875-5702. Phone: (334) 855-4764. Fax: (334) 855-4780. Email: firstname.lastname@example.org. Location Map: Click Here). The information contained in the counseling sheets is presented as a general educational and information guide. The counseling sheets are not intended to be used for instruction in medical treatment. The author cannot assume the medical or legal responsibility of having this information misinterpreted and considered as a prescription for any condition or any person.