NATIONAL INSTITUTES OF HEALTH

National Kidney and Urologic Diseases Information Clearinghouse

U.S. Department

of Health and

Human Services

What I need to know about

Bladder Control for Women Bladder Control for Women

What I need to know about

Bladder Control for Women

NATIONAL INSTITUTES OF HEALTH

National Diabetes Information Clearinghouse

Contents

Urine Leakage: A Common Health Problem for 

Women of All Ages ................................................................ 1

How does the bladder work?................................................. 2

What are the different types of bladder control 

problems? ................................................................................ 5

What causes bladder control problems? .............................. 7

How do I tell my health care team about my urine 

leakage?................................................................................... 9

How is loss of bladder control treated?.............................. 11

Hope Through Research...................................................... 17

For More Information.......................................................... 18

Acknowledgments................................................................. 19

*Inserts in back pocket

A. What Your Doctor Needs to Know

B. Your Daily Bladder Diary

C. Kegel Exercise Tips

D. Medicines for Bladder Control

Urine Leakage: A Common Health Problem

for Women of All Ages

You may think bladder control problems are something

that happen when you get older. The truth is that women

of all ages have urine leakage. The problem is also called

incontinence. Men leak urine too, but the problem is more

common in women.

● Many women leak urine when they exercise, laugh hard,

cough, or sneeze.

● Often women leak urine when they are pregnant or after

they have given birth.

● Women who have

stopped having their

periods—menopause—

often report bladder

control problems.

● Female athletes of all

ages sometimes have

urine leakage during

strenuous sports

activities.

1

Women of all ages have bladder

control problems.
Urine leakage may be a small bother or a large problem.

About half of adult women say they have had urine leakage

at one time or another. Many women say it’s a daily

problem.

Urine leakage is more common in older women, but that

doesn’t mean it’s a natural part of aging. You don’t have

to “just live with it.” You can do something about it and

regain your bladder control.

Incontinence is not a disease. But it may be a sign that

something is wrong. It’s a medical problem, and a doctor

or nurse can help.

How does the bladder work?

The bladder is a balloonshaped organ that stores

and releases urine. It sits in

the pelvis. The bladder is

supported and held in place

by pelvic muscles. The

bladder itself is a muscle.

The tube that carries urine

from your body is called the

urethra. Ring-like muscles

called sphincters help keep

the urethra closed so urine

doesn’t leak from the

bladder before you’re

ready to release it.

2

Parts of the bladder control system.

Urine Bladder

muscle

Urethra

Pelvic floor

muscles

Sphincter

muscles
3

Several body systems must work together to control the

bladder.

● Pelvic floor muscles hold the bladder in place.

● Sphincter muscles keep the urethra closed.

● The bladder muscle relaxes when it fills with urine and

squeezes when it’s time to urinate.

● Nerves carry signals from the bladder to let the brain

know when the bladder is full.

● Nerves also carry signals from the brain to tell the

bladder when it’s time to urinate.

● Hormones help keep the lining of the bladder and

urethra healthy.

Bladder control problems can start when any one of these

features is not working properly.

Parts of the bladder control system.

Womb Bowel

Pubic

bone

Pelvic floor

muscles

Anus

Vagina

Urethra

Leg

Pelvic floor

muscles

Side view Bottom view

Bladder

Urethra
4

Parts of the bladder control system: nerves and brain.

The brain sends nerve signals telling muscles to hold urine or let it out.

Nerves send signals to the brain.

The signals tell when the bladder is full or empty.
5

What are the different types of bladder

control problems?

Not all bladder control problems are alike. Some problems

are caused by weak muscles, while others are caused by

damaged nerves. Sometimes the cause may be a medicine

that dulls the nerves.

To help solve your problem, your doctor or nurse will try to

identify the type of incontinence you have. It may be one

or more of the following six types.

● Temporary incontinence. As the name suggests,

temporary incontinence doesn’t last. You may have an

illness, like a urinary tract infection, that causes frequent

and sudden urination that you can’t control. Or you may

find that a new medicine has the unexpected side effect

of increasing your urination. These problems go away as

soon as the cause is found and corrected.

● Stress incontinence. If you leak urine when you cough,

laugh, sneeze, or exercise, you have stress incontinence.

Mental stress does not cause stress incontinence. The

“stress” is pressure on the bladder. When

your pelvic and sphincter muscles are strong,

they can handle the extra pressure from a

cough, sneeze, exercise, or

laugh. But when those muscles

are weak, that sudden pressure

can push urine out of the

bladder.

In stress incontinence, weak pelvic muscles can let urine escape

when a cough or other action puts pressure on the bladder.
● Urge incontinence. If you leak urine after a strong,

sudden urge to urinate, you have urge incontinence.

This bladder control problem may be caused by nerve

damage from diabetes, a stroke, an infection, or another

medical condition.

● Mixed incontinence. Mixed incontinence is a mix of

stress and urge incontinence. You may leak urine with a

laugh or sneeze at one time. At another time, you may

have a sudden, uncontrollable urge to urinate just before

you leak.

● Functional incontinence. Some people have trouble

getting to the bathroom. If you have urine leakage

because you can’t walk or have other mobility problems,

you have functional incontinence.

● Overactive bladder. If you have to urinate eight or more

times a day, you may have an overactive bladder. Getting

up to urinate two or more times each night is another

sign of overactive bladder. With an overactive bladder,

you feel strong, sudden urges to urinate, and you also

may have urge incontinence.

6
What causes bladder control problems?

Urine leakage has many possible causes.

● Weak muscles. Most bladder control problems are

caused by weak pelvic muscles. These muscles may

become stretched and weak during pregnancy and

childbirth. Weak muscles let the bladder sag out of

position, which may stretch the opening to the urethra.

● Nerve damage. Damaged nerves may send signals to

the bladder at the wrong time. As a result, a bladder

spasm may push out urine without warning. Sometimes

damaged nerves send no signals at all, and the brain can’t

tell when the bladder is full. Nerves can be damaged by

diseases or trauma.

7

Weak pelvic muscles and strong pelvic muscles.

Strong pelvic muscles

Weak pelvic muscles

Urethra,

closed

Urethra,

open

Urine Bladder Urine Bladder
Diseases and conditions that can damage the nerves include

• diabetes

• Parkinson’s

• multiple sclerosis

• stroke

Trauma that can damage the nerves includes

• pelvic or back surgery

• herniated disc

• radiation

● Medicines, alcohol, and caffeine. Leaking can happen

when medicines affect any of the muscles or nerves. You

may take medicine to calm your nerves so that you can

sleep or relax. This medicine may dull the nerves in the

bladder and keep them from signaling the brain when

the bladder is full. Without the message and urge, the

bladder overflows. Drinking alcohol can also cause these

nerves to fail. Water pills—diuretics—take fluid from

swollen areas of your body and send it to the bladder.

This rapid filling may cause the bladder to leak. Caffeine

drinks such as coffee and cola also cause the bladder to

fill quickly. Make sure your drinks are decaf.

● Infection. A urinary tract infection can irritate bladder

nerves and cause the bladder to squeeze without warning.

This type of incontinence goes away once the infection

has been cured.

● Excess weight. Being overweight can put pressure on the

bladder and contribute to stress incontinence.

8
How do I tell my health care team 

about my urine leakage?

Talking about bladder control problems is not easy for some

people. You may feel embarrassed to tell your doctor. But

talking about the problem is the first

step in finding an answer. Also, you

can be sure your doctor has heard it

all before. You will not shock or

embarrass your doctor or nurse.

Medical History

You can prepare for your visit to the doctor’s office by

gathering the information your doctor will need to

understand your problem. Make a list of the medicines you

are taking. Include prescription medicines and those you

buy over the counter, like aspirin or antacid. List the fluids

you drink regularly, including sodas, coffee, tea, and

alcohol. Tell the doctor how much of each drink you have

in an average day.

9

Finding a Doctor

You will need to find a doctor who is skilled in helping

women with urine leakage. If your primary doctor shrugs

off your problem as normal aging, for example, ask for a

referral to a specialist—a urogynecologist or a urologist

who specializes in treating female urinary problems. You

may need to be persistent, or you may need to look to

organizations to help locate a doctor in your area. See

pages 18 and 19 for a list of organizations.
Make a note of any recent surgeries or illnesses you have

had. Let the doctor know how many children you have had.

These events may or may not be related to your bladder

control problem.

Finally, keep track of the times when you have urine

leakage. Note what you were doing at the time. Were

you coughing, laughing, sneezing, or exercising? Did you

have an uncontrollable urge to urinate when you heard

running water?

You can use the What Your Doctor Needs to Know (Insert A)

and Your Daily Bladder Diary (Insert B) included with this

booklet to prepare for your appointment.

Physical Exam

The doctor will give you a physical exam to look for any

health issues that may be causing your bladder control

problem. Checking your reflexes can show possible nerve

damage. You will give a urine sample so the doctor can check

for a urinary tract infection. For women, the exam may

include a pelvic exam. Tests may also include taking an

ultrasound picture of your bladder. Or the doctor may

examine the inside of your bladder using a cystoscope, a long,

thin tube that slides up into the bladder through the urethra.

Bladder Function Tests

Your exam may include one or more tests that involve

filling the bladder with warm fluid to measure the pressure

at which leakage may occur. One simple test is called a

stress test. You simply relax and then cough strongly to

see if urine escapes.

10
Any medical test can be uncomfortable. Bladder testing

may sound embarrassing, but the health professionals who

perform the tests will try to make you feel comfortable and

give you as much privacy as possible.

How is loss of bladder control treated?

Your doctor will likely offer several treatment choices. Some

treatments are as simple as changing some daily habits.

Other treatments require taking medicine or using a device.

If nothing else seems to work, surgery may help a woman

with stress incontinence regain her bladder control.

Talk with your doctor about which treatments might work

best for you.

Pelvic Muscle Strengthening

Many women prefer to try the simplest treatment choices

first. Kegel exercises strengthen the pelvic muscles and don’t

require any equipment. Once you learn how to “Kegel,” you

can Kegel anywhere. The trick is finding the right muscles to

squeeze. Your doctor or nurse can help make sure you are

squeezing the right muscles. Your doctor may refer you to a

specially trained physical therapist who will teach you to find

and strengthen the sphincter muscles. Learning when to

squeeze these muscles can also help stop the bladder spasms

that cause urge incontinence. After about 6 to 8 weeks, you

should notice that you have fewer leaks and more bladder

control. Use the pelvic muscle exercise log included with the

Kegel Exercise Tips sheet (Insert C) in this booklet to keep

track of your progress.

11
Changing Habits

Timed voiding. By keeping track of the times you leak

urine, you may notice certain times of day when you

are most likely to have an accident. You can use that

information to make planned trips to the bathroom ahead

of time to avoid the accident. Once you have established

a safe pattern, you can build your bladder control by

stretching out the time between trips to the bathroom.

By forcing your pelvic muscles to hold on longer, you

make those muscles stronger.

Diet changes. You may notice that certain foods and

drinks cause you to urinate more often. You may find that

avoiding caffeinated drinks like coffee, tea, or cola helps

your bladder control. You can choose the decaf version of

12

You can do Kegel exercises while lying down, sitting at a desk, or

standing up.
your favorite drink. Make sure you are not drinking too

much fluid because that will cause you to make a large

amount of urine. If you are bothered by nighttime

urination, drink most of your fluids during the day and limit

your drinking after dinner. You should not, however, avoid

drinking fluids for fear of having an accident. Some foods

may irritate your bladder and cause urgency. Talk with your

doctor about diet changes that might affect your bladder.

Weight loss. Extra body weight puts extra pressure on your

bladder. By losing weight, you may be able to relieve some

of that pressure and regain your bladder control.

Medicines

No medications are approved to treat stress urinary

incontinence. But if you have an overactive bladder, your

doctor may prescribe a medicine that can calm muscles and

nerves. Medicines for overactive bladder come as pills,

liquid, or a patch.

Medicines to treat overactive bladder can cause your eyes

to become dry. These medicines can also cause dry mouth

and constipation. If you take medicine to treat an

overactive bladder, you may need to take steps to deal

with the side effects.

● Use eye drops to keep your eyes moist.

● Chew gum or suck on hard candy if dry mouth bothers

you. Make it sugarless gum or candy to avoid tooth

decay.

● Take small sips of water throughout the day.

13
Medicines for other conditions also can affect the nerves and

muscles of the urinary tract in different ways. Pills to treat

swelling—edema—or high blood pressure may increase urine

output and contribute to bladder control problems.

Talk with your doctor; you may find that taking a different

medicine solves the problem without adding another

prescription. The list of Medicines for Bladder Control

(Insert D) included with this booklet will give you more

information about specific medicines.

Pessaries

A pessary is a plastic ring, similar to a contraceptive

diaphragm, that is worn in the vagina. It will help support the

walls of the vagina, lifting the bladder and nearby urethra,

leading to less stress leakage. A doctor or nurse can fit you

with the best shape and size pessary for you and teach you

how to care for it. Many women use a pessary only during

exercise while others wear their pessary all day to reduce

stress leakage. If you use a pessary, you should see your

doctor regularly to check for small scrapes in the vagina that

can result from using the device.

Nerve Stimulation

Electrical stimulation of the nerves that control the bladder

can improve symptoms of urgency, frequency, and urge

incontinence, as well as bladder emptying problems, in some

people. This treatment is usually offered to patients who

cannot tolerate or do not benefit from medications. At first,

your doctor will use a device outside your body to deliver

stimulation through a wire implanted under your skin to see

14
if the treatment relieves

your symptoms. If the

temporary treatment

works well for you, you

may be able to have a

permanent device

implanted that delivers

stimulation to

the nerves in your back,

much like a pacemaker.

The electrodes in the

permanent device are

placed in your lower

back through a minor

surgical procedure.

You may need to return to the doctor for adjustments to find

the right setting that controls your bladder symptoms.

Surgery

Doctors may suggest surgery to improve bladder control if

other treatments have failed. Surgery helps only stress

incontinence. It won’t work for urge incontinence. Many

surgical options have high rates of success.

Most stress incontinence problems are caused by the bladder

neck dropping toward the vagina. To correct this problem,

the surgeon raises the bladder neck or urethra and supports it

with a ribbon-like sling or web of strings attached to a muscle

or bone. The sling holds up the bottom of the bladder and

the top of the urethra to stop leakage.

15

A device can be placed under your skin

to deliver mild electrical pulses to the

nerves that control bladder function.

Electrical

stimulator

Tailbone

Nerves

Bladder
Catheterization

If your bladder does not empty well as a result of nerve

damage, you might leak urine. This condition is called

overflow incontinence. You might use a catheter to empty

your bladder. A catheter is a thin tube you can learn to

insert through the urethra into the bladder to drain urine.

You may use a catheter once in a while, a few times a day,

or all of the time. If you use the catheter all the time, it will

drain urine from your bladder into a bag you can hang from

your leg. If you use a catheter all the time, you should

watch for possible infections.

16

Urethra

Sutures

Pubic

bone

Bladder Bladder

Bladder

neck

Urethra

Sling material

Pubic

bone

Bladder

neck

Surgery to lift the bladder may use a web of strings (left) or a ribbonlike sling (right) to support the bladder neck and urethra.
Hope Through Research

The National Institute of Diabetes and Digestive and

Kidney Diseases (NIDDK) supports researchers who are

looking for the best ways to treat bladder control problems.

The NIDDK started the Urinary Incontinence Treatment

Network to gather information about the success of

different treatments for bladder control problems in

women. These studies will help doctors give better advice

to women about the short- and long-term results and side

effects of the treatments for urinary incontinence. The

NIDDK has also joined a team of organizations to form

the Women’s Urologic Health Program. The goal of this

program is to raise awareness among health care providers,

patients, and the public of the advances in the treatment

and prevention of women’s urologic conditions to improve

the quality of life for women with these conditions.

17

The U.S. Government does not endorse or favor any specific

commercial product or company. Trade, proprietary, or company

names appearing in this document are used only because they are

considered necessary in the context of the information provided.

If a product is not mentioned, the omission does not mean or

imply that the product is unsatisfactory.
For More Information

American Urogynecologic Society

2025 M Street, NW, Suite 800

Washington, DC 20036

Phone: 202–367–1167

Email: info@augs.org

Internet: www.augs.org

American Urological Association Foundation

1000 Corporate Boulevard

Linthicum, MD 21090

Phone: 1–866–RING–AUA (746–4282)

Email: patienteducation@auafoundation.org

Internet: www.auafoundation.org

www.UrologyHealth.org

National Association for Continence

P.O. Box 1019

Charleston, SC 29402–1019

Phone: 1–800–BLADDER (252–3337) or 843–377–0900

Email: memberservices@nafc.org

Internet: www.nafc.org

The Simon Foundation for Continence

P.O. Box 815

Wilmette, IL 60091

Phone: 1–800–23–SIMON (237–4666) or 847–864–3913

Email: simoninfo@simonfoundation.org

Internet: www.simonfoundation.org

18
Society of Urologic Nurses and Associates

P.O. Box 56

East Holly Avenue

Pitman, NJ 08071–0056

Phone: 1–888–TAP–SUNA (827–7862) or 856–256–2335

Email: suna@ajj.com

Internet: www.suna.org

Acknowledgments

The National Kidney and Urologic Diseases Information

Clearinghouse (NKUDIC) would like to thank the

following individuals for assisting with the scientific and

editorial review of this publication.

Toby Chai, M.D.

University of Maryland

Charles Nager, M.D.

University of California, San Diego

Halina Zyczynski, M.D.

University of Pittsburgh

Thank you also to Vicki McClelland, executive director of

the Free Medical Clinic of the Northern Shenandoah Valley

in Winchester, VA, for facilitating field-testing of this

publication.

19
National Kidney and Urologic Diseases

Information Clearinghouse

3 Information Way

Bethesda, MD 20892–3580

Phone: 1–800–891–5390

Fax: 703–738–4929

Email: nkudic@info.niddk.nih.gov

Internet: www.kidney.niddk.nih.gov

The National Kidney and Urologic Diseases Information

Clearinghouse (NKUDIC) is a service of the National Institute

of Diabetes and Digestive and Kidney Diseases (NIDDK). The

NIDDK is part of the National Institutes of Health of the U.S.

Department of Health and Human Services. Established in 1987,

the Clearinghouse provides information about diseases of the kidneys

and urologic system to people with kidney and urologic disorders

and to their families, health care professionals, and the public. The

NKUDIC answers inquiries, develops and distributes publications,

and works closely with professional and patient organizations and

Government agencies to coordinate resources about kidney and

urologic diseases.

Publications produced by the Clearinghouse are carefully reviewed by

both NIDDK scientists and outside experts.

This publication is not copyrighted. The Clearinghouse

encourages users of this booklet to duplicate and distribute as

many copies as desired.

This booklet is also available at www.kidney.niddk.nih.gov.

This publication may contain information about medications used 

to treat a health condition. When this publication was prepared, 

the NIDDK included the most current information available.

Occasionally, new information about medication is released. For

updates or for questions about any medications, please contact the

U.S. Food and Drug Administration at 1–888–INFO–FDA 

(463–6332), a toll-free call, or visit their website at www.fda.gov.

Consult your doctor for more information.

National Institute of Diabetes and 

Digestive and Kidney Diseases

NIH Publication No. 07–4195

August 2007

U.S. DEPARTMENT OF HEALTH 

AND HUMAN SERVICES

National Institutes of Health
What Your Doctor Needs to Know

To prepare for your doctor’s appointment, check all the boxes below

that apply to you. This information will help your doctor understan

your bladder control problem.

❑ I take these prescription medicines:

medicine: ________________________ dose: _________________

medicine: ________________________ dose: _________________

medicine: ________________________ dose: _________________

❑ I take these over-the-counter drugs (such as Tylenol, aspirin, or

Maalox):

medicine: ________________________ dose: _________________

medicine: ________________________ dose: _________________

medicine: ________________________ dose: _________________

If you take more medicines, please list them on a separate paper.

I started having bladder trouble

❑ within the past few months

❑ 1 to 2 years ago

❑ ________ years ago

❑ Number of babies I have had: ________

Dates: __________________________________________________

❑ My periods have stopped—menopause.

Date: ____________________________

❑ I had an operation.

Date: ____________________________

Type of operation: ________________________________________

National Kidney and Urologic Diseases Information Clearinghouse • 1–800–891–5390

www.kidney.niddk.nih.gov
❑ I recently hurt myself or have been sick.

Date: ____________________________

Type of injury or illness: ___________________________________

❑ I recently had a bladder—urinary tract—infection.

Date: ____________________________

❑ I smoke cigarettes.

❑ I have pain or a burning feeling when I urinate.

❑ I often have a really strong urge to urinate right away.

❑ Sometimes my bladder feels full, even after I finish urinating.

❑ I go to the bathroom often, but very little urine comes out.

❑ I don’t go out with friends or family because I worry about

leaking urine.

❑ The first thing I do at new places is check the bathroom location.

❑ I worry about being put in a nursing home because of bladder

control problems.

I have, or had, these medical problems:

❑ cancer ❑ depression

❑ crippling arthritis ❑ diverticulitis

❑ diabetes ❑ multiple sclerosis

❑ interstitial cystitis ❑ stroke

❑ spinal cord injury ❑ other_____________________

❑ urinary infection
Your Daily Bladder Diary

This diary will help you and your health care team figure out the

causes of your bladder control trouble. The “sample” line shows yo

how to use the diary.

Your name: ________________________________________________

Date: _____________________

Did you feel What were you

Trips to the Accidental a strong doing at the

Time Drinks Bathroom Leaks urge to go? time?

How How much Sneezing, exercising

many urine? How much? having sex, lifting,

What kind? How much? times? (circle one) (circle one) Circle one etc.

Sample Coffee 2 cups ✓ sm med lg sm med lg Yes No Running

6–7 a.m. Yes No

7–8 a.m. Yes No

8–9 a.m. Yes No

9–10 a.m. Yes No

10–11 a.m. Yes No

11–12 noon Yes No

12–1 p.m. Yes No

1–2 p.m. Yes No

2–3 p.m. Yes No

3–4 p.m. Yes No

4–5 p.m Yes No

5–6 p.m. Yes No

6–7 p.m. Yes No

✓

Use this sheet as a master for making copies that you can use as a bladder diary for as many days as

you need.
Did you feel What were you

Trips to the Accidental a strong doing at the

Time Drinks Bathroom Leaks urge to go? time?

How How much Sneezing, exercising

many urine? How much? having sex, lifting,

What kind? How much? times? (circle one) (circle one) Circle one etc.

Sample Soda 2 cans ✓ sm med lg sm med lg Yes No Running

7–8 p.m. Yes No

8–9 p.m. Yes No

9–10 p.m. Yes No

10–11 p.m. Yes No

11–12 Yes No

12–1 a.m. Yes No

1–2 a.m. Yes No

2–3 a.m. Yes No

3–4 a.m. Yes No

4–5 a.m. Yes No

5–6 a.m. Yes No

I used _______ pads today. I used ________ diapers today (write number).

Questions to ask my health care team: ________________________________________

__________________________________________________________________________

__________________________________________________________________________

__________________________________________________________________________

__________________________________________________________________________

Let’s Talk About Bladder Control for Women is a public health awareness campaign

conducted by the National Kidney and Urologic Diseases Information Clearinghouse

(NKUDIC), an information dissemination service of the National Institute of Diabetes

and Digestive and Kidney Diseases (NIDDK), National Institutes of Health.

✓

midnight
Kegel Exercise Tips

What are Kegel exercises?

To do Kegel exercises, you just squeeze your pelvic floor muscles.

The part of your body including your hip bones is the pelvic area.

At the bottom of the pelvis, several layers of muscle stretch between

your legs. The muscles attach to the front, back, and sides of the

pelvic bone.

Kegel exercises are designed to make your pelvic floor muscles

stronger. These are the muscles that hold up your bladder and help

keep it from leaking.

Building up your pelvic muscles with Kegel exercises can help with

your bladder control.

How do you exercise your pelvic muscles?

Find the right muscles. Try one of the following ways to find the

right muscles to squeeze.

1. Imagine that you are trying to stop passing gas. Squeeze the

muscles you would use. If you sense a “pulling” feeling, you

are squeezing the right muscles for pelvic exercises.

2. Imagine that you are sitting on a marble and want to pick up

the marble with your vagina. Imagine “sucking” the marble

into your vagina.

3. Lie down and put your finger inside your vagina. Squeeze

as if you were trying to stop urine from coming out. If you

feel tightness on your finger, you are squeezing the right

pelvic muscles.

National Kidney and Urologic Diseases Information Clearinghouse • 1–800–891–5390

www.kidney.niddk.nih.gov
Let your doctor, nurse, or therapist help you. Many people have

trouble finding the right muscles. Your doctor, nurse, or therapist

can check to make sure you are doing the exercises correctly. You

can also exercise by using special weights or biofeedback. Ask your

health care team about these exercise aids.

Don’t squeeze other muscles at the same time. Be careful not to

tighten your stomach, legs, or other muscles. Squeezing the wrong

muscles can put more pressure on your bladder control muscles.

Just squeeze the pelvic muscle. Don’t hold your breath.

Repeat, but don’t overdo it. At first, find a quiet spot to practice—

your bathroom or bedroom—so you can concentrate. Lie on the

floor. Pull in the pelvic muscles and hold for a count of 3. Then

relax for a count of 3. Work up to 10 to 15 repeats each time you

exercise. Use the Exercise Log on the other side of this sheet to

keep track of your sessions.

Do your pelvic exercises at least three times a day. Every day, use

three positions: lying down, sitting, and standing. You can exercise

while lying on the floor, sitting at a desk, or standing in the kitchen.

Using all three positions makes the muscles strongest.

Be patient. Don’t give up. It’s just 5 minutes, three times a day.

You may not feel your bladder control improve until after 3 to

6 weeks. Still, most women do notice an improvement after a

few weeks.
Week: ______________

My Pelvic Muscle Exercise Log

Sunday

● I exercised my pelvic muscles ____ times.

● I spent ____ minutes exercising.

● At each exercise session, I squeezed my pelvic muscles ____ times.

Monday

● I exercised my pelvic muscles ____ times.

● I spent ____ minutes exercising.

● At each exercise session, I squeezed my pelvic muscles ____ times.

Tuesday

● I exercised my pelvic muscles ____ times.

● I spent ____ minutes exercising.

● At each exercise session, I squeezed my pelvic muscles ____ times.

Wednesday

● I exercised my pelvic muscles ____ times.

● I spent ____ minutes exercising.

● At each exercise session, I squeezed my pelvic muscles ____ times.

Thursday

● I exercised my pelvic muscles ____ times.

● I spent ____ minutes exercising.

● At each exercise session, I squeezed my pelvic muscles ____ times.

Friday

● I exercised my pelvic muscles ____ times.

● I spent ____ minutes exercising.

● At each exercise session, I squeezed my pelvic muscles ____ times.

Saturday

● I exercised my pelvic muscles ____ times.

● I spent ____ minutes exercising.

● At each exercise session, I squeezed my pelvic muscles ____ times.

Use this sheet as a master for making copies that you can use to record your exercises week after wee

Medicines for Bladder Control

Medicines for bladder control generally work by blocking signals tha

may cause muscle spasms in the bladder. A group of drugs called

antispasmodics are usually the first drugs your doctor will consider

for treating bladder control problems. Another group of medicines,

called tricyclic antidepressants, may be considered, although these

drugs are primarily intended to treat depression. Tricyclic

antidepressants can calm nerve signals and decrease spasms in

the bladder muscles.

Antispasmodics

National Kidney and Urologic Diseases Information Clearinghouse • 1–800–891–5390

www.kidney.niddk.nih.gov

Other Names for This Medicine

Brand Name Generic Name

Detrol

Ditropan

Enablex

Levsin

Sanctura

VESIcare

tolterodine

oxybutynin chloride

darifenacin

hyoscyamine

trospium chloride

solifenacin succinate

Brand Name Generic Name

Detrol LA

Ditropan XL

tolterodine extended release

oxybutynin extended release

Extended-release forms of oxybutynin and tolterodine are now

available.
Oxybutynin also comes in a patch that may decrease the side effects

(see below).

Brand Name Generic Name

Oxytrol oxybutynin patch delivery

system

Other Names for This Medicine

Brand Name Generic Name

Elavil

Pamelor

Sinequan

Tofranil

amitriptyline

nortriptyline

doxepin

imipramine

Side effects. Antispasmodics can cause your eyes to become

sensitive to light. These medicines also keep you from sweating and

can cause dry mouth. If you take any of these medicines, you may

need to take a few steps to deal with side effects.

● Wear sunglasses if your eyes become more sensitive to light.

● Take care not to become overheated.

● Chew gum or suck on sugarless hard candy to avoid dry mouth.

Tricyclic Antidepressants

Side effects. Tricyclic antidepressants can cause your vision to blur

when you read, dry mouth, constipation, and light-headedness when

you stand after sitting.
Antidiuretic 

Other Names for This Medicine

Brand Name Generic Name

DDAVP

DDAVP Nasal Spray

DDAVP Rhinal Tube

DDVP

Stimate Nasal Spray

desmopressin

desmopressin

desmopressin

desmopressin

desmopressin

Desmopressin is a man-made form of a natural hormone that your

body makes. The hormone, called antidiuretic hormone (ADH) or

vasopressin, directs the kidneys to make less urine. The urine is

therefore more concentrated. Desmopressin is not usually

prescribed for adult women with overactive bladder or stress

incontinence. It is more often used to treat bedwetting in children.

It is also used to treat a condition called diabetes insipidus.

Side effects. Desmopressin rarely causes side effects, but you should

call your doctor if you have headaches, stomach cramps, nausea,

reddening of the skin, a stuffy or runny nose, or pain in the genital

area.
Interstitial Cystitis Medicine 

Pentosan is approved to treat the symptoms of bladder pain, urinary

frequency, and urinary urgency that characterize interstitial cystitis,

also known as painful bladder syndrome. Doctors do not know

exactly how it works, but one theory is that it may repair defects

that might have developed in the lining of the bladder.

Side effects. Pentosan’s side effects are limited primarily to minor

gastrointestinal discomfort. A small minority of patients experience

some hair loss, but hair grows back when they stop taking the drug.

Researchers have found no negative interactions between pentosan

and other medications.

Your doctor will order regular blood tests to monitor your liver

function while you take pentosan.

Because pentosan has not been tested in pregnant women, the

manufacturer recommends that it not be used during pregnancy,

except in the most severe cases.

Other Names for This Medicine

Brand Name Generic Name

Elmiron pentosan polysulfate sodium

All drugs—even those sold over the counter—have potential

side effects. Patients should always consult a doctor before

using any drug for an extended amount of time.