Loss of bladder control is a common problem. Learn why it
happens, and what you can do about it.
Incontinence:
What Is It?
Urinary incontinence, or loss of
bladder control, is a frustrating problem for millions of Americans. Never
knowing when and where you might have an accident can affect everything from
work to exercise to your social life. Urinary incontinence happens to both men
and women but is more common in women. Studies show that at least half of older
women may have some form of incontinence.
Stress
Incontinence: Symptoms
The main symptom of incontinence is
when you pee unexpectedly -- when and how depends on the type of incontinence.
If you leak a bit when you laugh, cough, sneeze, jog, or lift something heavy,
you may have stress incontinence. This is the most common bladder control
problem in younger women.
Causes
Stress incontinence happens when the
muscles and tissue around the opening of the bladder get weak. When there is
more pressure against the bladder and this opening does not stay closed,
leakage happens. Pressure from coughing or laughing may be all it takes to leak
urine. There are a few reasons why these muscles can lose strength. They may be
stretched by weight gain, a sports injury, or pregnancies and vaginal
childbirths.
Urge
Incontinence: Symptoms
If you often have a desperate need
to pee but can't get to the bathroom in time, you may have urge incontinence.
The sudden urge can come from hearing the sound of running water or sipping a
drink. Or there may not be any reason for it. With this type of incontinence,
you may leak large amounts of urine. You may also find yourself running to the
bathroom even when your bladder is mostly empty.
Causes
A sudden, overwhelming need to pee
might be caused by spasms of the bladder muscles. These spasms can come from
nerve or muscle damage. In some cases, the damage might come from an illness
like a stroke, or an infection or inflammation of the bladder.
Overactive
Bladder
Overactive bladder is another name
for urge incontinence. You get the same sudden, frequent need to pee. But not
everyone with overactive bladder has incontinence. Many women are able to “hold
it” until they get to the toilet. Instead of leaking urine, the big problem for
them is constantly having to stop what they're doing to go to the
bathroom.
Medications
That Worsen Incontinence
There are several medicines that can
cause incontinence or make it worse. In women, some high blood pressure
medicines can relax the bladder muscles, leading to stress incontinence. Some
types of antidepressants can make incontinence worse, although some may relieve
the symptoms. And diuretics or "water pills" create more urine, which
adds to the problem.
Emotional
Toll of Incontinence
Incontinence is not dangerous, but
it can wear you down. Research shows that women with incontinence have lower
self-esteem, a less active sex life, and higher levels of depression compared
to those with healthy bladders. You might want to stay home and hide, but it
doesn't have to be that way. Incontinence can be managed or even reversed.
Diagnosing
Incontinence
The first step is to find out
exactly what kind of incontinence you have. Your health care provider will ask
about your medical history and probably get for a urine sample to check for a
urinary tract infection. He or she may ask you to stand and cough, a way to
signal stress incontinence. You may also be asked to keep a diary showing how
much you drink, how much you pee, and how often you leak.
Tests
There are several tests to help
pinpoint the cause of incontinence. Ultrasound imagery can show how the bladder
and urethra change when you pee or cough. A pad test shows how much urine you
pass throughout the day. A bladder stress test helps check for stress
incontinence. Cystometry measures bladder pressure and can help diagnose urge
incontinence. An MRI scan (seen here) may show problems that can't be seen with
other tests.
Managing
Mild Incontinence
Many women with mild incontinence
can stop leaks by drinking less. Try pouring your cups half-full, and stay away
from coffee, tea, and sodas with caffeine. Caffeine can create more urine,
making you go more often. Another strategy is to empty your bladder regularly,
every two to four hours, whether you need to go or not.
Kegel
Exercises
Because stress incontinence comes
from weak pelvic muscles, consider trying to strengthen those muscles. You can
do this with Kegel exercises: Clench the muscles you would use to stop the flow
of urine. Hold the squeeze for 10 seconds, then relax. Do three or four sets
every day. As these muscles get stronger, so will your bladder control.
Biofeedback
Biofeedback is a method that gives
you real-time information about activity in your bladder and pelvic muscles. As
you learn more about these functions, you may be better able to control them.
Biofeedback is often used in along with Kegel exercises.
Pessary
When lifestyle adjustments don't
help, you may need to talk to your doctor. If you have stress incontinence, a
pessary may help. This is a device that can be put into the vagina to help cut
down on the leakage. You can wear it continuously or only as needed, such as
during a hard workout.
Bladder
Training
Bladder training can be help with
both stress incontinence and urge incontinence. The first step is to make a
chart of what times you go to the bathroom and when you leak. After studying
the patterns, you can avoid accidents by heading to the bathroom before a leak
might happen. It's also possible to train your bladder to hold out for longer
and longer periods between bathroom visits.
Medications
for Incontinence
For urge incontinence, doctors often
suggest anticholinergic medicines. These pills or patches block some of the
nerves in the bladder muscle. Studies show that taking the meds with bladder
training works well. Botox injections into the bladder muscle can relax the
bladder, which allows it to hold more urine. Botox injections aren't permanent,
but they can last up to eight or nine months in the bladder. They can be
repeated, too.
Surgery
for Incontinence
Surgery for stress incontinence can
be an outpatient procedure. For urge incontinence, a doctor can implant a
device that stimulates nerves near the bladder and controls spasms with
electrical signals (shown here). For stress incontinence, doctors can place the
bladder in a "sling" -- a piece of tissue or material that holds the
bladder up and prevents leaks. Another procedure pulls the bladder up to a more
normal position without a sling.
Incontinence
Products
Urinary incontinence products like
panty liners, adult diapers, and plastic-coated underwear might help, too. You
can find products like these in drugstores or medical supply stores. Protective
bedding, such as a plastic mattress protector, may also be useful.
Preventing
Incontinence
There are ways to lower your risk of
incontinence. Keep a healthy weight and do daily Kegel exercises. If you smoke,
try to quit. Smoking can lead to chronic coughing, which can stress the bladder
and cause leaks.
Source:
Web MD
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