How to manage your lower urinary tract symptoms depends on the type and severity of your symptoms.

Lifestyle and behaviour changes

While specific treatments are available for each type of symptom, making lifestyle and behaviour changes is important for everyone when appropriate. To help manage your symptoms:

• Keep a voiding diary: Track when and how often you urinate. This can help you and your healthcare provider understand your symptoms better and see how things change over time. This can make it easier to determine what works for you.
• Eat a balanced diet: A balanced diet with plenty of fruits, vegetables, whole grains, and lean proteins can help improve your overall health.
• Stop or reduce smoking: Nicotine can increase the frequency and urgency of urination, leading to more discomfort. Smoking also affects blood flow, which can make it harder for your body to function normally, including for urination.
• Limit certain drinks: Limiting caffeine, alcohol, and fizzy (carbonated) drinks can help reduce your lower urinary tract symptoms. These drinks can make your symptoms worse, so small changes in what you drink can often improve your symptoms.
• Bladder training: If you have symptoms of an overactive bladder, bladder training may help. Your healthcare team may also give you tips on how much to drink and when.
• Using pads or incontinence products: Using pads or incontinence products can help you manage leakage, offering comfort and confidence while you explore treatment options for your lower urinary tract symptoms.
• Physical activity: Regular exercise can improve bladder control and reduce symptoms. Activities like walking, swimming, or cycling are great for overall health and can ease pressure on your bladder.
• Weight management: Keeping a healthy weight can reduce pressure on your bladder, making your symptoms less severe. Staying active and eating a balanced diet can help with weight management and improve your health.

Making these lifestyle changes can improve your symptoms and quality of life. Work with your healthcare team to find the best plan for you.

Medicines

Different medicines can help manage lower urinary tract symptoms. Your healthcare provider may suggest specific medicines based on the type and severity of your symptoms:

• Alpha-blockers: These medicines are often used if you have symptoms like a weak urine stream or difficulty starting urination. They work by relaxing the muscles in the prostate and bladder, making it easier to urinate.
• 5-alpha reductase inhibitors: If you have an enlarged prostate, these medicines can help shrink your prostate and improve urine flow over time. They are often used for moderate to severe symptoms of an enlarged prostate. They can take up to 6 months to work.
• Antimuscarinics: These medicines help symptoms of an overactive bladder by controlling bladder sensations, reducing the urge to go.
• Beta-3 agonists: These medicines can help treat overactive bladder by reducing the intensity of bladder sensations, allowing it to store more urine and reduce the frequency of urination.
• Diuretics: Sometimes, if you get up at night frequently, your healthcare provider may recommend a diuretic in the late afternoon to help your body get rid of excess fluid during the day. This can reduce nighttime urination.
• PDE5 inhibitors: These medicines, commonly used to treat erectile dysfunction, can also help with lower urinary tract symptoms. PDE5 inhibitors work by relaxing the muscles in the prostate and bladder, which can improve symptoms like difficulty urinating or incomplete bladder emptying.

Your healthcare team will choose the right medicine for you based on your specific symptoms, overall health, and how severe your symptoms are. It’s important to follow your healthcare team’s instructions and discuss any side effects or concerns.

Surgery

Some people may want to explore surgical options instead of medicine to avoid potential side effects. Some of these treatments may not be covered by the Alberta Health Care Insurance Plan, and you may need to pay for them. In some cases, you may also need to travel outside of Alberta for surgical treatments. Talk with your healthcare team to see what might be best for you.

Pelvic floor physiotherapy

Depending on your symptoms, pelvic floor physiotherapy may be a helpful option. Pelvic floor physiotherapy focuses on strengthening and relaxing the muscles of the pelvic floor, which can improve bladder control, reduce urgency, and help with other urinary symptoms.

You do not need a referral to get physiotherapy, but only certain physiotherapists have the training to perform pelvic health assessment, diagnosis, and treatment. Not all pelvic floor physiotherapy treatments are covered by the Alberta Health Care Insurance Plan, so there may be extra costs involved.

Alberta Health Services community physiotherapists also offer free pelvic health webinars for Albertans.

Urethral milking

Urethral milking is a technique that can help some people with lower urinary tract symptoms, particularly those who have trouble emptying their bladder completely. Urethral milking involves gently pressing or massaging the area near the base of the penis to help release any urine that may be stuck in the urethra.

To do urethral milking:

1. After urinating, wait a few seconds to let your bladder finish emptying.
2. Place your fingertips about 3 finger widths behind the scrotum, then gently massage forward and upward towards the base of the penis, beneath the scrotum. This technique helps push any remaining urine into the tube from the bladder to the outside, where it can be emptied by shaking or squeezing as usual.
3. Repeat the process 2 times to make sure the urethra is fully emptied.
4. Tighten your pelvic floor muscles strongly (hold for up to 10 seconds), then relax. This can help prevent any dribbling after you are done urinating.