You're toiling on the treadmill, Stairmaster, or recumbent bicycle -- and the accident happens: a little urinary incontinence. Small leaks can occur whether you're a teen or a woman in her 20s and upward. Often incontinence starts after childbirth or as the result of athletic injuries. Some men have incontinence problems after prostate surgery.
"Unfortunately, people [with incontinence] stop doing things they enjoy, like high-impact aerobics," says Roger Dmochowski, MD, a urologist and director of the Vanderbilt Continence Center in Nashville, Tenn.
Bladder suspension refers to surgery that helps place a sagging bladder back into its normal position. Is this type of surgery right for you? Here are answers to some of the most common questions, from who may need this procedure to possible complications.
"The problem is, the leakage is variable, not predictable," he tells WebMD. "You can have a small amount of leakage one time and a huge leakage another. That's what makes people nuts."
Your Strategy for Handling Incontinence
Stick with black. Loose-fitting, dark-colored workout clothes work best if you have incontinence -- especially if you need to wear an incontinence pad.
Watch the fluids. If you have an incontinence problem, don't have any caffeinated drinks beforehand (sodas, coffee, tea). The caffeine acts as a diuretic -- which leads to leaks. It’s still important to stay hydrated when exercising by drinking water.
Forget spicy foods. Spicy foods like Mexican or Chinese fare will irritate your bladder, and worse the type of incontinence called urge incontinence. High-acid foods like cranberry juice, orange juice, and other citrus beverages also cause irritation and trigger incontinence problems. Try to minimize those foods -- and maximize veggies and other mild, high-fiber foods.
Use a tampon. For women, a tampon puts pressure on the urethra which prevents leaks, explains Vani Dandolu, MD, MPH, a urogynecologist with Temple University School of Medicine in Philadelphia. "It mainly helps with stress incontinence, where leaks happen with an activity," she tells WebMD.
Kegels will help. Exercises to strengthen the muscle that controls your bladder -- Kegel exercises -- will make a big difference in your little problem. Kegel exercises help with mild to moderate stress incontinence, which commonly occurs after having children. To do Kegels, contract the muscles that you would use to stop the flow of urine. Hold the contraction for three seconds and then relax. Do this eight to 10 times, at least three times a week. If you don’t notice improvement after three to four months, check with your doctor to see if it would help to see a physical therapist to make sure you’re doing the exercises correctly.
Try a pessary. If you have stress incontinence or incontinence due to a prolapsed uterus, a pessary can also help. This is a round object (made of silicone, rubber, or plastic) which is worn in the vagina to prevent leakage. "I have patients who have worn a pessary for 10 to 15 years," Dandolu tells WebMD. "You wear it during the day, and take it out at night."
Work on timing. With urge incontinence, "bladder training" can lengthen the time between restroom visits. Take planned bathroom trips every two to four hours -- so the clock dictates your habits, not your bladder. This helps prevent the “urge” to go and the possible leakage.
SOURCES: Roger Dmochowski, MD, urologist; director, Vanderbilt Continence Center, Nashville, Tenn. Vani Dandolu, MD, MPH, urogynecologist, Temple University School of Medicine, Philadelphia. WebMD Features: "A Woman's Little Secret" and "6 Ways Diet Worsens Urinary Incontinence."