Behavioral modification

1. Detrusor instability (urge incontinence) may respond to dietary restriction of caffeine, alcohol, chocolate, and spicy food, as these can all cause bladder irritation. Scheduled toileting should be offered to incontinent patients. Bladder training (timed voiding) helps to progressively distend the bladder and allows the patient to regain control over voiding patterns. The patient is instructed to void at pre-assigned times during the waking hours. The initial voiding interval is set at less than the current voiding interval and is gradually increased.

2. Kegel's exercise. Pelvic muscle exercises are used in stress urinary incontinence and detrusor instability (urge incontinence). A typical regimen of pelvic floor exercises is based on sets of contractions of the levator muscles performed 2-4 times daily. This regimen results in a 6070% improvement in their symptoms.

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