Why do I leak urine when I cough or feel sudden urges?

Question

Hello doctor,

I am a 55-year-old woman experiencing sudden urges to urinate with occasional leakage, especially when I cough or laugh. My urinalysis was normal, but I have to use the washroom every hour during the day and twice at night. I was prescribed Tolterodine, but it causes dry mouth.

Are there safer alternatives or pelvic floor exercises that could help manage this without side effects?

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I have read your query, and I am deeply concerned about your worries.

First, try to identify the contributing factors.

Before adjusting treatment, check for reversible causes:

Caffeine, alcohol, and carbonated drinks can irritate the bladder. If you use excessive amounts of these products, stop it
Constipation worsens bladder pressure.
Weight gain increases pressure on the pelvic floor. If your BMI (body mass index) is more than 25, then you should decrease your weight.
Certain medications (for example, Diuretics) may increase frequency.

Then try some pelvic floor muscle training (such as Kegel exercises). Kegels strengthen the muscles that support the bladder and urethra. Here are the steps on how you can do them:

Empty your bladder, then tighten pelvic muscles for five seconds.
Relax for five seconds.
Repeat ten to 15 times, eight contractions three times a day.
Gradually work up to holding for ten seconds each contraction.

You can also do some bladder training. It helps you in increasing the bladder capacity and reducing urgency. Gradually extend the time between voids by 15 minutes every few days. Use relaxation or distraction when an urge occurs (deep breathing, pelvic contractions). Over time, aim for voiding every three to four hours during the day.

Now, for the medical management, you can take Tablet Flavoxate Hydrochloride (HCL) 200mg. One tablet morning and night for one month.

I hope this answers your query.

Please let me know if I can assist you further.

Thank you.