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    Too Embarrassed To Tell Your Doc?


    BEST FIXES Try behavioral therapy strategies. For both overactive bladder and combo symptoms, they can improve or even resolve incontinence, say University of Minnesota researchers, who reviewed 99 studies:

    A BLADDER DIARY Track when you went, what you were doing just before, and your food and drink intake for three days. Since urge incontinence is often tied to specific cues, a diary can help you uncover them. "You may discover you always have urges in the same situations, such as when you put the key in the front door or when you go from a warm environment to a cold one," says Michael Guralnick, M.D., associate professor of urology at the Medical College of Wisconsin. "You may find connections with drinking large amounts of fluid or with certain beverages. I've got plenty of sophisticated diagnostic equipment, but the bladder diary is one of the best tools for seeing patterns and finding solutions."

    BLADDER RETRAINING You set times for bathroom breaks, then gradually increase the intervals between them. "The goal is to break your bladder's cycle of going whenever it feels like it," explains Dr. Guralnick. "By delaying for a few more minutes every few weeks, you're training it to hold more urine and to stay relaxed so you have time to walk to the bathroom."

    MIND-BODY THERAPIES Hypnotherapy with visualization techniques and mindfulness-based stress reduction are both showing promise for urge incontinence. In one small study, the hypnotherapy/mental-imagery approach helped cut the average number of urge episodes by at least half per week.

    Anna Raisor, 56, who works in website technology for a large corporation, had mixed stress and urge incontinence that began in her 30s and kept her from meeting friends for dinner or taking her two children on outdoor adventures. "I went for help when it got so bad I couldn't get in the door after work without an accident," says Raisor, who lives in Oak Park, IL. "The training helped me learn to relax and hold it, even on the commuter train."

    QUICK FLICKS Kegels also come in handy, says Florendo: "When you have the urge to go, doing a couple of fast squeezes - called 'quick flicks' - can calm the bladder."

    STILL LEAKING? Try acupuncture. In one Oregon Health and Science University study of 85 women, just four weekly sessions reduced accidents 59%. And there are many medications - tolterodine (Detrol) and solifenacin (Vesicare) are well-known ones - your doctor may prescribe.

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