The Knack

Stress urinary incontinence can cause you to leak when you cough, sneeze or lift something. The pelvic floor muscles usually contract automatically when pressure hits the bladder, keeping the urethra sealed shut. But if your muscles do not contract quickly enough or with enough force, you may leak urine.
The key to not leaking is to use your pelvic muscles just in time to squeeze the urethra shut. This well-timed muscle use is referred to as “the Knack." The Knack closes your urethra at the critical moment of potential urine loss.
Learning to use the pelvic muscles at the right time is a skill like learning any other new muscle activity. At first it might be hard, but with practice many can learn how to remain dry.

HOW TO DO IT

The way to prevent stress incontinence is to squeeze your pelvic floor muscles fast and hard just before and during whatever activities cause you to lose urine. Then relax. For example, as you are about to cough, squeeze your pelvic floor muscles. Keep squeezing them while you cough, then relax them when the coughing is over.

Certain activities, such as tennis or jogging, are extended activities. It is not possible to keep you muscles squeezed thought the entire activity. In such cases, you can reduce leakage by squeezing during the most physically stressful moments, such as swinging the racquet during tennis. During more sustained activities like jogging, you can reduce leakage by squeezing and relaxing you pelvic floor muscles off and on throughout the activity.

Questions or comments about this Web site may be sent to
coe@obgyn.ucsf.edu. Last updated: 09/15/2009

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