Simple self-management techniques are often suggested as a first-line treatment for urinary incontinence, and while they might well help decrease the frequency and amount of urine leakage, not enough research has been done to recommend them as a first step in treatment.

Researchers at the University of North Carolina at Chapel Hill enrolled more than 220 women (nearly two-thirds of whom were middle-aged) who reported urinary incontinence into a study of self-management techniques. All women wore a urine pad, kept a diary of leakage and intake of fluid and caffeine for two days, and completed a questionnaire about the impact of incontinence on their lives. The women then were randomized into two groups. The intervention group received individualized counseling on fluid intake, voiding frequency, caffeine consumption, pelvic floor muscle exercise, and constipation. The control group was taught only the pelvic floor muscle exercise (although they received the rest of the counseling at the end of the study period).

After three weeks, the intervention group showed decreased urine loss, fewer incontinence episodes, and increased quality-of-life scores. The women in the control group had a slight increase in urine loss and no change in quality of life. The intervention was most effective among women who had reported frequent daily incontinence episodes, were over age 65, and were premenopausal or undergoing hormone replacement therapy.

According to study coauthor Molly Dougherty, a nurse, "The results show that symptoms of urinary leakage are improved by simple steps that are within the scope of any nurse's practice and that women can carry out with limited guidance. This should encourage nurses to ask their patients about urine loss."