Treatment Of Urinary Incontinence
Treatment usually begins with bladder training and Kegel exercises. Avoiding physical stresses that cause loss of urine and losing weight may help control incontinence. Pseudoephedrine may be useful in women with bladder outlet incompetence. Imipramine may be used for mixed stress and urge incontinence Urge incontinence Urinary incontinence is involuntary loss of urine. Incontinence can occur in both men and women at any age, but it is more common among women and older people, affecting about 30% of older women… read more or for either separately. Duloxetine is also used for stress incontinence. If stress incontinence is caused by atrophic urethritis or vaginitis, estrogen cream is often effective. For people with stress incontinence, urinating frequently to avoid a full bladder is often helpful.
For stress incontinence that is not relieved with drugs and behavioral measures, surgery or devices such as pessaries may be helpful. The vaginal sling procedure creates a hammock of support to help prevent the urethra from opening during coughing, sneezing, or laughing. Most commonly, a sling is created from synthetic mesh. Mesh implants are effective, but a few people with mesh implants have serious complications. Alternatively, doctors can create a sling using tissue from the abdominal wall or leg. In men with stress incontinence, a mesh sling or an artificial urinary sphincter implant may be placed around the urethra to prevent leakage of urine.
Alternative Treatments For Nocturia
Many people turn to complementary and alternative medicine before seeking medical help. You may also be interested in alternative medications or treatments for nocturia, but there are few studies to support their use. These treatments may work for nocturia, but only if OAB is the cause.
For example, research has found that:
- herbal medications have a positive impact on symptoms of OAB and quality of life
- acupuncture provides short-term relief for OAB symptoms
- homeopathic remedies may have benefits, but need more studies
- alternative treatments have fewer side effects than medications
- saw palmetto berry extract has no benefit for nocturia
But more research is needed to confirm if CAM works for OAB.
Always talk to your doctor before trying a supplement or alternative treatment. Certain CAM treatments can cause unintended side effects, especially if youre already taking medication.
What Causes Bladder Control Problems
Incontinence is a symptom with a wide variety of causes. The most common causes include the following:
- Urinary tract infection
- Side effect of medication: Examples include alpha-blockers, calcium channel blockers, antidepressants, antihistamines, sedatives, sleeping pills, narcotics, caffeine-containing preparations, and water pills . Occasionally, the medicines used to treat some forms of incontinence can also worsen the incontinence if not prescribed correctly.
- Impacted stool: Stool becomes so tightly packed in the lower intestine and rectum that a bowel movement becomes very difficult or impossible.
- Weakness of muscles in the bladder and surrounding area: This can have a variety of causes.
- Blocked urethra, usually due to enlarged prostate
- Prior prostate, bladder, or pelvic surgery
- Nerve damage or neurological diseases
Many of the causes are temporary, such as urinary tract infection. The incontinence improves or goes away completely when the underlying condition is treated. Others are longer lasting, but the incontinence can usually be treated.
Risk factors: Underlying causes or contributors to urinary incontinence include the following:
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Losing Weight May Help To Improve Your Bladder Control
Excess weight puts extra stress on your pelvic floor muscles and contributes to an overactive bladder and loss of bladder control. If you can lose even a small amount of weight, it will help with bladder control.
The best weight loss plans are always those that set realistic goals combined with healthy eating habits and physical activity. Fad diets, although often successful short-term, rarely achieve sustainable weight loss, because once you tire of the diet, you often revert to ingrained unhealthy eating habits.
Check out our Obesity and Weight Loss guide for more information.
Nocturia Causes: Why Do I Pee So Much At Night
So, what causes you to go to the bathroom at night to urinate so frequently? There are a variety of medical conditions that can cause nocturia, which can include a urinary tract infection , a form of overflow incontinence, pregnancy, aging in older adults, diuretic fluid intake or drinking too close to bedtime.More plainly, frequently urinating at night can also be a symptom of having an overactive bladder.
An overactive bladder is another common cause of nocturia, which is the result of bladder muscles that spasm and contract involuntarily, even when your bladder isnât full. This can send you running to the bathroom â or, as can be the case with nighttime incontinence, wetting the bed. An overactive bladder is often the result of nerve damage caused by previous pelvic surgery, or a neurological disease such as multiple sclerosis or Parkinsonâs. In some cases, a particularly difficult birthing process can cause damage to the surrounding muscles, tissues and nerves surrounding the bladder, leaving you with a sensitive bladder.
Our bodies produce less urine while weâre sleeping. However, this means that the urine we do produce is more concentrated and acidic, which can aggravate a sensitive bladder, causing it to spasm and wake you up at night having to pee.
Other times, nocturia is a result of too much urine production. This is usually due to an underlying medical problem that should be ruled out with your doctor, such as:
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Continence Problems And Bladder Or Bowel Issues
Incontinence and continence problems are symptoms of bladder or bowel dysfunction. They tell you that something is not quite right. Pelvic floor muscle weakness is a common cause of these symptoms. Changes to the nerves controlling the bladder, bowel or pelvic floor can also result in loss of control.Sometimes, other health problems such as diabetes, stroke, Parkinsons disease or multiple sclerosis can cause bladder or bowel control problems.
Try To Avoid Caffeine Carbonated Drinks Sugar Alcohol And Spicy Or Acidic Foods
- Caffeine is a diuretic which makes you need to use the bathroom more often.
- Carbonated drinks and sugar are thought to stimulate the bladder.
- Alcohol switches off the ability of your body to concentrate urine. This means you tend to urinate more dilute, watery urine, which dehydrates you. Since you are dehydrated, you may drink more.
- Acidic or spicy food may aggravate your overactive bladder and worsen your symptoms. Certain acidic fruit and juices like orange, grapefruit, lemon and lime can aggravate your bladder, too.
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What Bladder Issue Do You Have
The most common ones women face during and after menopause are:
Stress incontinence. You might lose a few drops of urine when youre coughing, sneezing, or laughing. Or you might notice leaking when youre lifting something heavy or doing something that puts pressure on your bladder.
Urge incontinence. The need to pee comes on fast and unexpectedly. You might not make it to a bathroom in time. This is sometimes called an irritable or overactive bladder.
Nocturia. Some women wake up several times in the middle of the night with an urge to pee.
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Bladder Incontinence In Women
Bladder incontinence is more common in women than in men. Other than the possible causes listed above, some things that may increase risk of bladder incontinence in women are:
- Changes to urinary or vaginal tissue from hormone therapy, surgery, chemotherapy, or targeted therapy
- Hormonal changes from menopause
- Pelvic prolapse – the bladder, uterus, and or rectum may slip backward or downward into the vaginal canal because of weak pelvic wall muscles
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What Are Home Remedies For Bladder Control Problems
Incontinence is never normal. If you have a problem with urine leakage, you should see a medical professional.
While waiting for your appointment, make yourself more comfortable.
- Avoid foods and drinks that may irritate the bladder. These include alcohol, caffeine, carbonated drinks, chocolate, citrus fruits, and acidic fruits and juices.
- Do not drink too much fluid 6-8 cups a day is adequate, but you may need more if you are exercising, sweating a lot, or the weather is hot. In people with kidney stone disease, voiding at least 2 liters of fluid per day is important. Fluid restriction may lead to stone growth or formation.
- Urinate regularly.
- Do not ignore the urge to urinate or to have a bowel movement.
- If you are overweight, try to lose weight and reach a healthier weight.
- If necessary, wear absorbent pads to catch urine.
- Maintain proper hygiene. This will help you feel more confident and will prevent odors and skin irritation.
Kegel exercises: Exercising the muscles of your pelvic floor may benefit women with either stress or urge incontinence.
Create a urination diary. Take notes every day on your urination patterns. This will help your health-care provider in diagnosing your problem:
- Time of urge to urinate
- Strength of pain or urge
- Time you actually urinated
- Amount of leakage
- Type and amount of fluids you drink and when you drink them
What Causes Bladder Leaks
There are two main types of urinary incontinence:
If you have this type, activities that raise the pressure inside your abdomen cause urine to leak through the ring of muscle in your bladder that normally holds it in. Coughing, sneezing, jumping and lifting heavy objects could lead to a leak.
Going through childbirth, smoking or being overweight can raise the risk of stress incontinence for women, Wright says. Stress incontinence in men is rare, and when it arises, its often due to prostate cancer treatment, such as radiation or surgery.
With this type, your brain, spinal cord and bladder dont work together properly to allow you to hold and release urine at the right time. Your bladder may suddenly empty itself without warning. Or you may feel like you need to urinate frequently, a problem called overactive bladder.
Some diseases that affect the nervous system, such as multiple sclerosis or stroke, can cause this kind of incontinence, says Wright. In men, an enlarged prostate may be the culprit. But in many cases, doctors dont know what causes urge incontinence.
It is possible to have both types of incontinence at the same time.
TRY IT: Keep Records
Your doctor will want to know as much as possible about your bladder leakswhen they occur, how much urine comes out, and what youre doing when leaks happen. Consider keeping a diary of when you urinate and when you have leaks, recommends Wright.
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Managing Bladder Or Urinary Incontinence
Sometimes urinary incontinence can last a short time, depending on what’s causing it. But sometimes incontinence can be long-term and uncomfortable, making some everyday activities difficult to manage.
Your health care team will ask you questions to determine the type of bladder incontinence you might have. Then, you might need tests to verify the type and learn the cause of it which will help them know the best way to manage it.
- Pelvic floor muscle strengthening may be recommended. A physical therapist that specializes in pelvic floor muscle exercises can help. This might help muscle strength and bladder control get better by doing exercises that tighten and relax muscles that control the flow of urine.
- Bladder training canhelp manage how often you need to urinate throughout the day, by assigning certain time intervals to empty your bladder.
What Is An Overactive Bladder Symptoms To Look For
Overactive bladder is a syndrome, or a set of symptoms, that is believed to be due to sudden contractions of the muscles in the wall of the bladder. When you have overactive bladder syndrome, the muscles controlling bladder function start acting involuntarily. This often leads to urinary incontinence or loss of bladder control. The urine leakage experienced by someone with OAB can be as little as several drops to up to several ounces. Sometimes, incontinence can be a sign of something simple like drinking way too many caffeinated beverages on a daily basis. Other times the underlying cause can be something more serious.
An overactive bladder is said to account for 40 to 70 percent of incontinence. What is incontinence? Incontinence is a lack of voluntary control over urination or defecation. When you have overactive bladder, you can experience urinary incontinence or loss of control over urination.
There are actually two different types of overactive bladder. Dry is when you have a sudden, urgent need to urinate many times during the day. Wet means you have the sudden, urgent need to urinate and you experience bladder leakage, which is also referred to as urge incontinence. Both dry and wet can occur without any underlying health condition. An estimated 60 percent of OAB patients have dry OAB while 40 percent have wet OAB .
OAB symptoms can differ on an individual case basis. Common symptoms of an overactive bladder include:
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Medical Treatments For Nocturia
Your doctor may prescribe medications when preventive measures and lifestyle changes fail to reduce the frequency of your nighttime urination. Doctors prescribe a class of drugs called anticholinergics to treat symptoms of OAB, if thats the cause of your nocturia. They reduce bladder spasms that create the urge to go.
Your doctor may suggest you take a diuretic for regular urine production. A diuretic can itself cause nocturia. But if you take it early enough in the day, it may help you get rid of excess fluid while youre awake. This should decrease your urine production at night.
Other drugs that may help are:
- desmopression in cases of diabetes insipidus to cause the kidneys to produce less urine
- tamsulosin , finasteride , or dutasteride to treat prostate enlargement
- antibiotics if you have a urinary tract infection
Your doctor may also adjust your diabetic medications to lower your blood sugar if theyre causing nocturia.
Living With Bowel Or Bladder Incontinence
There is no single, right way to cope with bladder or bowel incontinence. The challenge is to find what is best for your situation, so you can get the help you need and return to a normal daily life. Talk with your health care team if you notice a change in bowel or bladder habits, and about the best ways to manage incontinence, if it is a problem. You might find it helpful to talk with other people who are dealing with incontinence, too. Ask a member of your cancer care team about support groups in your area.
Here are some things you can do that may help make incontinence less of a problem:
- Empty your bladder every 3 to 4 hours while awake, to avoid accidents.
- Empty your bladder before bedtime or before strenuous activity.
- Limit drinks with caffeine, or and avoid alcohol and citrus juices, which can irritate the bladder and make you have to go more often.
- Avoid hygiene products that may irritate you Women should avoid feminine spray or over-the-counter vaginal suppositories.
- Because belly fat can push on the bladder, avoiding weight gain or losing needed weight sometimes helps improve bladder control.
- Avoid tobacco use which can cause coughing and bladder irritation due to harmful substances in tobacco products.
- Talk to your doctor about all medicines, vitamins, herbs, and supplements youre taking. Some may affect urine control.
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Risk Factors For Bedwetting
Gender and genetics are among the main risk factors for developing bedwetting in childhood. Both boys and girls may experience episodes of nocturnal enuresis during early childhood, usually between ages 3 and 5. But boys are more likely to continue to wet the bed as they get older.
70 percent if both parents had bedwetting as children.
Bedwetting is also more common among children diagnosed with attention deficit hyperactivity disorder . Researchers dont yet fully understand the relationship between bedwetting and ADHD.
When To Seek Medical Advice
See a GP if you have any type of urinary incontinence. Urinary incontinence is a common problem and you should not feel embarrassed talking to them about your symptoms.
This can also be the first step towards finding a way to effectively manage the problem.
Urinary incontinence can usually be diagnosed after a consultation with a GP, who will ask about your symptoms and may do a pelvic or rectal examination, depending on whether you have a vagina or a penis.
The GP may also suggest you keep a diary in which you note how much fluid you drink and how often you have to urinate.
Find out about diagnosing urinary incontinence.
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Essentials For Older People: Urinary Incontinence
Although incontinence is more common among older people, it is not a normal part of aging.
With aging, bladder capacity decreases, ability to delay urination declines, involuntary bladder contractions occur more often, and bladder contractions weaken. Thus, urination becomes more difficult to postpone and tends to be incomplete. The muscles, ligaments, and connective tissue of the pelvis weaken, contributing to incontinence. In postmenopausal women, decreased estrogen levels lead to atrophic urethritis and atrophic vaginitis and to decreasing the strength of the urethral sphincter. In men, prostate size increases, partially obstructing the urethra and leading to incomplete bladder emptying and strain on the bladder muscle. These changes occur in many normal, continent older people and may facilitate incontinence but do not cause it.
). These effects, such as constipation, dry mouth, blurred vision, and sometimes even confusion, can be particularly troublesome in older people.