Incontinence: ways to take control

Urinary incontinence can lead to some unpleasant situations—including "accidents" in public—that may leave you feeling scared to leave the house. Take control of your incontinence, and feel comfortable in your own skin by following this advice.

• The term "overactive bladder" may have been dreamed up by marketing gurus at some pharmaceutical company, but the reality is that up to 25 percent of women and five percent of men under 65 experience some form of urinary incontinence at some point. And the numbers are much higher for those who are older.
• It's embarrassing, smelly and one of the major reasons older people end up in nursing homes. Follow these five tips to stay dry.

• These exercises strengthen the pelvic floor muscles, which help control the release of urine. The stronger the muscles are, the less likely you are to have an accident. In fact, Kegels are even better than medication at improving existing incontinence. They are particularly effective in pregnant women and in men who have undergone surgery for prostate cancer.
• You can do them anytime, anywhere because no one knows you're doing them. First, figure out which muscles to target by stopping in midstream when you're urinating. The muscles you use to do this are your pelvic floor muscles. To perform Kegels, squeeze those muscles and hold for a count of 10. Relax, then repeat. Perform at least three sets of 10 contractions a day.

• You'll lose weight, which studies find is one of the most effective ways, next to pelvic floor exercises, to prevent incontinence. Always dole out appropriately-sized portions onto your dinner plate and leave the platter on the stove or elsewhere in the kitchen—not on the dinner table—where you'll be tempted to go for seconds.
• Another trick: use the smallest dinner plates you own. The plate will be fuller, so it will look like you're eating more.

• Doctors think one reason for incontinence is that some people tend to go too often. This can reduce the amount your bladder can hold and teaches your bladder muscles to send "must go" signals even when your bladder is barely half full. If you find yourself going every hour or two, try bladder training. Numerous studies find that this approach, which strengthens bladder muscles, improves incontinence, so there's good reason to think it could help prevent it in the first place.
• One way to train your bladder is to start out by going to the bathroom every hour whether you have to or not. The next day, go every hour and a half. Continue to increase the time between bathroom visits by 30 minutes a day until you're going about every few hours, or whatever time frame works best for you to prevent incontinence. Also, make sure you empty your bladder after each meal.

• If you're a tea drinker, you're more likely to develop incontinence, according to a large Norwegian study. It may or may not be due to the caffeine: researchers suspect that tea contains other chemicals that contribute to incontinence, although they don't yet know what they are.
• There is a link between caffeine and incontinence if you drink more than four cups a day.

• Studies suggest that women who have hysterectomies, the most common gynecological surgeries in the world, are twice as likely to later require surgery for urinary incontinence than women who don't have them. Many hysterectomies are medically unnecessary: if your doctor recommends one, ask about other options and get a second opinion.