Counseling Sheet

Agatha M. Thrash, M.D.
Preventive Medicine

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This is the loss of some urine with any effort in the trunk, e.g. straining to lift, sneezing, or coughing.

Stress incontinence is the most common cause of involuntary loss of urine in women and is often associated with loss of normal position of the uterus and/or bladder and relaxation of the lower pelvic muscles and urethra. It can occur in men after prostate surgery, or injury to the bladder neck.

Kegel's exercises strengthen the muscles of the floor of the pelvis, thus affecting control of bladder and bowel emptying. The floor of the pelvis should be tightened as in stopping urine flow or bowel elimination, or even the overall trunk effort in putting pressure into blowing hard, like blowing up a balloon. With practice it is possible to sense just the contraction of the pelvic floor muscles. One set of exercises is to do 10 to 15 of such contractions; in two to three months strength improves.

Another exercise is to interrupt the stream of urine several times (e.g. 5 times), while the bladder is emptying.

Another exercise is simply to hold the urine for awhile after the bladder is full, for 5, 10, or more minutes.