If you leak when you cough, sneeze or lift

A simple technique to control leakage

How to do the Paper Towel Test

The Paper Towel Test

You’re not alone!

There is a technique that can help you feel more confident about never leaking, or if you do, it’s only a few drops. 

How much do you worry about leaking when your bladder is under pressure?

Do you feel you might leak when you cough, sneeze, or exercise?

Can a timed contraction of your pelvic muscles increase your bladder confidence?

For many women, sneezing, laughing or lifting can cause worry about leaking.

Fold a few paper towels until they are about 4 inches by 9 inches (or about the size of an envelope).Cover the top of the paper towels with a colored tissue.Tape the colored tissue to the paper towel (layer an old washcloth underneath if you want more absorption)Make at least 2 of these test pads.

What do you need to take the paper towel test?

Make your own test pads

Some tri-folded paper towels about 4 inches wide by 9 inches long and darker in color.

Paper towels and maybe a couple of old washclothsColored tissueTapeA felt-tip marker

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Find out how to make your own test pads

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A felt-tip marker

You’ll need:

When your bladder is full enough that you would normally go to the bathroom. Often this is when you first wake up.

When is the best time to take the paper towel test?

First, wipe away any vaginal wetness. This way, any wetness you see during the test is from urine leakage only.

Wipe yourself dry with a tissue or toilet paper.

Next, hold a clean tri-fold paper towel lightly against your bare vagina.

If you don’t leak at all, try coughing even harder.

1

When you are ready, cough really hard three times while holding the paper towel in place against your bare vagina.

2

After you’ve coughed, set the paper towel down and immediately outline the area of wetness with the marker. It’s okay if the wetted area continues to widen beyond the marking.

5

Round 1

4

If you soak the paper towel on your first cough, there’s no need to keep coughing.

Even though you don’t have this condition, contracting your pelvic floor muscles when you cough, sneeze, or lift is still a great lifetime habit that will help you stay confidently in control of your bladder.

If both paper towels are really wet...

You likely have a condition called stress incontinence, which is what Bladder health experts refer to as leakage that happens when the bladder is pushed down by “mechanical stress”, like a cough.

Both pads were really wet...

If the first towel is wet and second is less wet or dry...

Both pads were dry...

The good news is, you were able to tighten your pelvic floor muscles, giving the bladder better support and closing your urethra just when you need it most.

Doing a pelvic muscle contraction did not help. Your results show that the cough pushing down on your bladder makes your bladder leak.

You probably do not have a condition called stress incontinence, which is what Bladder health experts refer to as leakage that happens when the bladder is pushed down by “mechanical stress”, like a cough.

Compare the Results

One pad was wet, the other was less wet or not wet at all...

For you, that leakage is not reduced by your attempts to support the bladder and close the urethra with a pelvic muscle contraction at the same time as the cough.

If both paper towels are dry...

For help with stopping leakage, share photos of your paper towel test results with your health care provider.Remember to mark the photos so you know which test was done while tightening your pelvic muscles and which was not.

You’ll do the paper towel test again, coughing just as hard as before. But this time, just when you cough, tighten your pelvic floor muscles and hold throughout the coughs…

Round 2

Wipe yourself dry.

Next, hold a new paper towel lightly against your bare vagina.

When you are ready, cough really hard 3 times while at the same time contracting your pelvic floor muscles.

After you’ve coughed, set the paper towel down, and immediately outline the area of wetness with the marker.

As before, wipe away any vaginal wetness.

Try repeating the test again to see if you get the same results. Also, try the test in reverse order — tightening and holding your pelvic floor muscles during the first round of the test, but not the second.

Your bladder is very full You have at least 4 test towels Do the paper towel test twice while standing Fold and hold the tri-fold paper the same way for both tests

You can stand in the shower or tub while doing the test if you think leakage might be a lot

Instructions:

Pre-test Checklist

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