Filed under: Boomer's Health
Urinary incontinence — the loss of bladder control — is a common and often embarrassing problem. The severity of urinary incontinence ranges from occasionally leaking urine when you cough or sneeze to having an urge to urinate that's so sudden and strong you don't get to a toilet in time.
If urinary incontinence affects your day-to-day activities, don't hesitate to see your doctor. In most cases, simple lifestyle changes or medical treatment can ease your discomfort or stop urinary incontinence.
Urinary incontinence is the inability to control the release of urine from your bladder. Some people experience occasional, minor leaks — or dribbles — of urine. Others wet their clothes frequently.
Types of urinary incontinence include:
When to see a doctor
You may feel uncomfortable discussing incontinence with your doctor. But if incontinence is frequent or is affecting your quality of life, seeking medical advice is important for several reasons:
Urinary incontinence isn't a disease, it's a symptom. It can be caused by everyday habits, underlying medical conditions or physical problems. A thorough evaluation by your doctor can help determine what's behind your incontinence.
Causes of temporary urinary incontinence
Certain foods, drinks and medications can cause temporary urinary incontinence. A simple change in habits can bring relief.
Easily treatable medical conditions also may be responsible for urinary incontinence.
Causes of persistent urinary incontinence
Urinary incontinence can also be a persistent condition caused by underlying physical problems or changes, including:
Changes with aging. Aging of the bladder muscle leads to a decrease in the bladder's capacity to store urine and an increase in overactive bladder symptoms. Risk of overactive bladder increases if you have blood vessel disease, so maintaining good overall health — including stopping smoking, treating high blood pressure and keeping your weight within a healthy range — can help curb symptoms of overactive bladder.
After menopause women produce less estrogen, a hormone that helps keep the lining of the bladder and urethra healthy. With less estrogen, these tissues may deteriorate, which can aggravate incontinence.
These factors increase your risk of developing urinary incontinence:
Complications of chronic urinary incontinence include:
If you have urinary incontinence, you're likely to start by seeing your family doctor or a general practitioner. However, in some cases when you call to set up an appointment, you may be referred immediately to a urologist or a urogynecologist if you are a woman.
Because appointments can be brief, and because there's often a lot of ground to cover, it's a good idea to be well-prepared. Here's some information to help you get ready, and what to expect from your doctor.
What you can do
Your time with your doctor is limited, so preparing a list of questions ahead of time can help you make the most of your time together. List your questions from most important to least important in case time runs out. For urinary incontinence, some basic questions to ask your doctor include:
In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask additional questions during your appointment.
What to expect from your doctor
Your doctor is also likely to ask you questions. Being ready to answer them may reserve time to go over points you want to spend more time on. Your doctor may ask:
Common tests and processes for urinary incontinence include:
If further information is needed, you may undergo additional testing, including:
Treatment for urinary incontinence depends on the type of incontinence, the severity of your problem and the underlying cause. Your doctor will recommend the approaches best suited to your condition. A combination of treatments may be needed.
In most cases, your doctor will suggest the least invasive treatments first, so you'll try behavioral techniques and physical therapy first and move on to other options only if these techniques fail.
Behavioral techniques and lifestyle changes work well for certain types of urinary incontinence. They may be the only treatment you need.
Bladder training. Your doctor may recommend bladder training — alone or in combination with other therapies — to control urge and other types of incontinence. Bladder training involves learning to delay urination after you get the urge to go. You may start by trying to hold off for 10 minutes every time you feel an urge to urinate. The goal is to lengthen the time between trips to the toilet until you're urinating every two to four hours.
Bladder training may also involve double voiding — urinating, then waiting a few minutes and trying again. This exercise can help you learn to empty your bladder more completely to avoid overflow incontinence. In addition, bladder training may involve learning to control urges to urinate. When you feel the urge to urinate, you're instructed to relax — breathe slowly and deeply — or to distract yourself with an activity.
Pelvic floor muscle exercises. These exercises strengthen your urinary sphincter and pelvic floor muscles — the muscles that help control urination. Your doctor may recommend that you do these exercises frequently. They are especially effective for stress incontinence, but may also help urge incontinence.
To do pelvic floor muscle exercises (Kegel exercises), imagine that you're trying to stop your urine flow. Squeeze the muscles you would use to stop urinating and hold for a count of three and repeat.
With Kegel exercises, it can be difficult to know whether you're contracting the right muscles and in the right manner. In general, if you sense a pulling-up feeling when you squeeze, you're using the right muscles. Men may feel their penises pull in slightly toward their bodies. To double-check that you're contracting the right muscles, try the exercises in front of a mirror. Your abdominal, buttock or leg muscles shouldn't tighten if you're isolating the muscles of the pelvic floor.
If you're still not sure whether you're contracting the right muscles, ask your doctor for help. Your doctor may suggest you work with a physical therapist or try biofeedback techniques to help you identify and contract the right muscles. Your doctor may also suggest vaginal cones, which are weights that help women strengthen the pelvic floor.
Often, medications are used in conjunction with behavioral techniques. Drugs commonly used to treat incontinence include:
Several medical devices are available to help treat incontinence. They're designed specifically for women and include:
If other treatments aren't working, several surgical procedures have been developed to fix problems that cause urinary incontinence.
Some of the commonly used procedures include:
Absorbent pads and catheters
If medical treatments can't completely eliminate your incontinence — or you need help until a treatment starts to take effect — you can try products that help ease the discomfort and inconvenience of leaking urine.
Protecting your skin
Problems with urine leakage may require you to take extra care to prevent skin irritation. Some things you can do to protect your skin include:
Making the toilet more convenient
If you have urge incontinence or nighttime incontinence:
If you have functional incontinence, possible changes may include:
There are no alternative medicine therapies that have been proven to cure urinary incontinence. Some treatments, such as hypnotherapy, magnetic stimulation and reflexology, have been tried, but there is no definitive evidence that any of these therapies can help reduce symptoms. One therapy that has shown some promise in reducing the symptoms of urinary incontinence is acupuncture. However, more research is needed before it can be recommended as a treatment.
If you're embarrassed about having a bladder control problem, you may try to cope on your own — wearing absorbent pads, carrying extra clothes, avoiding going out. You may even cut back on drinking liquids — and risk dehydration — to avoid wetting episodes.
But there are better ways to manage urinary incontinence, and effective treatments are available. That's why it's important to see your doctor and ask about treatment. You'll be on your way to regaining an active and confident life — and control of your bladder.
Urinary incontinence is not always preventable. However, you may be able to decrease your risk of incontinence with these steps:
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