9 Smart Ways to Manage a Leaky Bladder

Drinking less water and other fluids to decrease your risk of an accident is not a good idea, says Tomas Griebling, MD, a professor of urology at the University of Kansas Medical Center in Kansas City. While it’s true that chugging down a lot of fluids — especially in a short amount of time — can lead to bladder leaks, not drinking enough can also make you need to pee suddenly.

“When you don’t drink enough water, the urine becomes more concentrated, and that can be irritating to the bladder and increase urgency,” explains Dr. Griebling.

How much fluid is enough varies from person to person, but the National Association for Continence (NAFC) estimates that six to eight 8-ounce (oz) glasses of water a day is about the right amount. Checking the color of your urine can help you know if you’re on target, according to Harvard Health Publishing. In general, a pale yellow color means you’re adequately hydrated, while a darker yellow suggests you need to drink more.

Griebling says that going to the bathroom on a schedule, say, every two to three hours, even if you don’t feel the urge to urinate, is a good idea for people who have urinary incontinence or overactive bladder (a condition in which the bladder can spasm, causing an intense, sudden urge to urinate). Similarly, emptying your bladder before leaving the house or other venues, such as your office or a restaurant, even if you don’t feel an urge to go, can diminish leakage and prevent accidents.

If you have urinary incontinence, it’s a good idea to know where the bathrooms are located at unfamiliar destinations, such as restaurants, museums, shopping centers, and parks. Try finding a map or directory ahead of time online.

Keeping track of your bathroom habits with a bladder diary can reveal patterns and triggers that help your doctor pinpoint the cause of your incontinence, Griebling says. A few days before your doctor visit, begin writing down what you drink, what time you drink it, how many times you urinate, and when you have leaking-urine episodes. Include anything that may have led up to an accident, such as coughing, exercising, or a sense of urgency.

Kegels, or pelvic floor muscle exercises, can benefit both men and women who have urinary incontinence by strengthening the muscles that support the bladder. This, in turn, helps prevent urine leaks and the feeling of urgency that comes with overactive bladder. And Kegels couldn’t be easier to do: Per the National Institute of Diabetes and Digestive and Kidney Diseases, simply squeeze or tighten your pelvic floor muscles — these are the same muscles you use to stop the flow of urine or passing gas — for a count of three, and then slowly relax them for a count of three. Kegels are so easy, you can do them anytime — even while sitting in your car at a stoplight or at your desk at work. Build up to doing one set of 10 to 15 squeezes, three times a day, and your bladder control should improve within six weeks.

You may be able to lower your risk of leaking urine by losing weight. Carrying extra weight, especially around your middle, puts stress and extra pressure on the pelvic floor muscles, which then can cause accidental urine leaks, note experts at The Simon Foundation for Continence. In a landmark study published in The New England Journal of Medicine, women who lost 17 pounds (lb) over six months reduced leaking episodes nearly 50 percent, while those who lost only 3 lb reduced leaking episodes by 28 percent.

Certain foods and beverages might irritate the lining of your bladder, making you need to sprint to the bathroom more often to avoid peeing on yourself.  While every bladder irritant doesn’t affect every person, there are two top culprits: caffeine and alcohol. “Caffeine is bothersome for many people,” confirms Griebling. “Alcohol and caffeine are diuretics, and they can be irritating to the bladder. I encourage patients to limit caffeine and alcohol intake to help reduce the urgency they may feel.”

Along with alcohol and beverages with caffeine, such as coffee, tea, and cola, other potential bladder irritants, according to the Johns Hopkins Women’s Center for Pelvic Health, include:

• Apples and apple juice
• Artificial sweeteners
• Carbonated beverages
• Chili and spicy foods
• Chocolate
• Citrus fruit and juices
• Cranberries and cranberry juice
• Milk products
• Pineapple
• Sugar and honey
• Tomatoes
• Vinegar

You may want to try eliminating one or more of these potential triggers from your diet for two weeks, then reintroduce them one by one every few days to see if you notice a difference in your urge to pee, how often you need to go, or the number of leaks you experience.

People who have urinary incontinence should do what they can to stop smoking. “Studies have found that people who smoke are more prone to incontinence,” says urologist Yvonne Koch, MD, a board-certified urologist in private practice based in Miami. “Smoking damages the very small blood vessels in our bodies and causes tissue weakness,” she explains. Furthermore, smoking can lead to coughing, which can cause urine leakage by putting pressure on the pelvic floor muscles. Plus, cigarette smoking triples the risk of bladder cancer, an early sign of which may be the need to urinate often or the urge to urinate immediately, even when the bladder isn’t full, according to Memorial Sloan Kettering Cancer Center.

Many medications can contribute to urinary incontinence, according to Harvard Health Publishing, including:

• Diuretics, such as furosemide (Lasix) and bumetanide (Bumex), which increase the production of urine by the kidneys.
• Muscle relaxants and sedatives, such as diazepam (Valium) and lorazepam (Ativan), which relax the urethra, increasing the need to pee. They also may make you less likely to notice when your bladder is full.
• Narcotics, such as morphine (OMS) and oxycodone (Oxycontin), which relax the bladder, causing it to retain urine. This increases the risk of “overflow incontinence” (leaking between bathroom visits) because it’s difficult for the bladder to empty completely.
• Antihistamines also relax the bladder.

If you suspect your prescription or over-the-counter medications may be causing or worsening your incontinence, gather them up and “bring as many of your medications as possible with you to the doctor,” Griebling advises. That way, your doctor can determine if any dosages should be changed, if you should stop taking some of them, or if there are alternative medications without this side effect.

Learn more in our Managing Urinary Incontinence Guide.