Behavioral and Nonpharmacological Treatments;
For most patients with urge or stress incontinence, the first line of treatment should be behavioral therapy.
Simple lifestyle changes are helpful in mild cases of incontinence.
As a first step, fluid restriction and avoidance of caffeine and alcohol, especially in the evening, are recommended.
If the patient is obese, it is recommended to lose weight.
Bladder Training:
This technique allows patients to control their urination reflexes by training them to urinate at scheduled times.
To determine the type of incontinence and frequency of incontinence, the patient is asked to keep a urination record for approximately 1 week.
A timed voiding program is then developed with shorter intervals than the patient's usual incontinence intervals.
Timed Voiding:
It is a passive toilet assistance program for patients in need of care.
The aim is to prevent the frequency of incontinence rather than to improve bladder function.
The caregiver prepares a specific timed voiding schedule for the patient, including at night.
There is no attempt to delay urination or resist the urge to urinate, as in bladder training.
Pelvic Floor exercises (Kegel exercises):
It is designed to strengthen the periurethral and perivaginal muscles.
It is useful in stress type incontinence, but it can also be effective in urge and mixed type incontinence.
Patients are first told how to contract their muscles and are asked to tighten their muscles in the genital area as if they want to hold in urine.
Once the correct muscles are identified, patients are instructed to contract these muscles for 10 seconds and relax them for 10 seconds.
This exercise should be repeated 30-80 times a day.
Patients are then instructed to contract their pelvic muscles before and during incontinence to prevent incontinence..
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