How To Talk To Your Doctor About Bladder Leaks
How do you bring up urinary incontinence to your doctor? And what do you say? Hereâs a helpful guide to get the conversation going!
An easy way to begin the conversation is describing the bladder issues you are experiencing. For example, you could start by saying, âI pee a little when I laugh or cough,â or, âI wake up with wet sheets,â or even simply, âMy bladder leaks.â
Every healthcare professional will tell you that the more information, the better. A good diagnosis depends largely on the information you can give your doctor when you talk. The questions listed below can help facilitate a productive conversation about your sensitive bladder with your doctor that will allow you to start discussing next steps.
- When do you experience urinary losses?
- How often do you urinate each day?
- How often do you get up during the night to use the restroom?
- How much liquid do you drink daily?
- Do you experience unexpected leaks? Do you leak when you sneeze, cough or exercise?
- Do bladder leaks prevent you from participating at work or in your social life?
Your healthcare professional may also decide to perform a physical examination. They may be looking to inspect the way your abdomen contracts. They may also check the firmness of your pelvic floor when you cough.
Related Conditions And Causes Of Urinary Incontinence
Fecal incontinence is light to moderate bowel leakage due to diarrhea, constipation, or muscle or nerve damage.
As described in the section above on causes of urinary incontinence, common conditions may contribute to chronic urinary incontinence, including: urinary tract infection , constipation, interstitial cystitis or other bladder conditions, nerve damage that affects bladder control, side effects from a prior surgery, and neurological disorders.
Products And Medical Devices
You may be able to use the following products to help stop or catch leaks:
Adult undergarments are similar in bulk to normal underwear but absorb leaks. You can wear them under everyday clothing. Men may need to use a drip collector, which is absorbent padding held in place by close-fitting underwear.
A catheter is a soft tube you insert into your urethra several times a day to drain your bladder.
Inserts for women can help with different incontinence-related issues:
- A pessary is a stiff vaginal ring you insert and wear all day. If you have a prolapsed uterus or bladder, the ring helps hold your bladder in place to prevent urine leakage.
- A urethral insert is a disposable device similar to a tampon that you insert into the urethra to stop leaks. You put it in before doing any physical activity that usually causes incontinence and remove it before urinating.
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How To Prevent A Leaky Bladder
- Limit or avoid excess caffeine intake through coffee, tea, and carbonated beverages.
- Perform Kegel exercises on regular basis to maintain strength of pelvic floor muscles.
- Avoid fluid intake for several hours before bedtime.
- Limit fluid intake throughout the day, but keep hydrated.
- Avoid smoking as tobacco use increases risk of bladder cancer, which can cause bladder leaks.
- Maintain a healthy weight as obesity can lead to bladder leakage.
- Urinate after sexual intercourse to eliminate bacteria from the urethra.
- Limit or avoid spicy foods, acidic foods, and artificial sweeteners, as they increase fluid output.
- Use caution with diuretics to prevent bladder leakage from frequent urination.
Diagnosis Of Urinary Incontinence
Its important to determine the type of urinary incontinence that you have and by seeing your symptoms the doctor will tell which type of urinary incontinence you have. The doctor will begin with the physical exam. The doctor will recommend this after the physical examination is done:
- Bladder diary: For many days record how much you drink, when you urinate, note the amount of urine you produce, whether you had an urge to urinate and the instances of incontinence episodes.
- Urinalysis: A sample of the urine is checked for the signs of infection, the traces of blood or other abnormalities.
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What Is Urinary Incontinence Symptoms Causes Diagnosis Treatment And Prevention
Urinary incontinence , the involuntary loss of urine, is a very common condition that no one wants to talk about. Because of the stigma that surrounds it, many people are too humiliated to seek help. But most conditions that cause UI can be corrected with medical or alternative interventions.
Occurring much more often in women than men, UI happens when the muscles in the bladder that control the flow of urine contract or relax involuntarily, resulting in leaks or uncontrolled urination. UI itself is not a disease, but it can be a symptom of an underlying medical issue.
What Are The Symptoms Of Incontinence
The main symptom of incontinence is a leakage of urine. This could be a constant dripping of urine or an occasional experience of leakage. If you have incontinence, you might have large amounts or small amounts of leaked urine. You might experience leakage for a wide variety of reasons often depending on the type of incontinence you have.
You might leak urine when you:
- Have an urge to urinate, but cant make it to the toilet on time.
- Have to get up in the middle of night to urinate .
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Forms Of Urinary Incontinence That Affect Men Only
- Benign prostatic hyperplasia affects about 50 percent of men over the age of 60, and 90 percent over the age of 85 an enlarged prostate can cause sudden and frequent urges to urinate.
- Peyronies disease is the result of injury or damage to penile tissue, causing an abnormal curvature.
- Painful inflammation of the prostate gland
Different Types Of Incontinence
There are different types of incontinence that may occur for different reasons. However, reflex incontinence is a serious condition that requires analysis to determine the cause.
Even so, the diagnosis and treatment for some of the different types of incontinence are similar:
- Stress incontinence occurs due to pressure on the bladder from physical activities.
- Overflow incontinence also known as dribbling after urination, which happens due to the failure of the bladder to empty itself.
- Mixed incontinence here, you will experience both stress and other types of incontinence.
- Functional incontinence this is caused by serious illnesses, such as dementia, where you may not be physically or mentally able to reach a bathroom in time.
Determining the type of incontinence you are dealing with should be done by a professional. The doctor may perform one of the following tests to create a proper diagnosis: Urinalysis, blood test, urine culture, cystoscopy, or a cough stress test.
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Bladder Leakage 3 Things Women Should Know About Urinary Incontinence
To dispel misconceptions, a urogynecologist discusses the surprisingly common, lingering issue many women experience.
Bladder leakage. For some women, the condition runs their life from the inside, preventing them from playing outside with their kids, going to a workout class or staying the night with family or friends.
And theyre not alone. Living with some degree of urinary incontinence, defined as an uncontrolled leakage of urine, is actually common, according to Pamela Fairchild, M.D., a urogynecologist at Von Voigtlander Womans Hospital at Michigan Medicine.
She says that approximately half of all women over the age of 20 experience some degree of incontinence. This means urinary incontinence isnt just an issue that affects elderly or postpartum women, although aging and childbirth are risk factors.
But if so many women experience it, then why does the topic still seem embarrassing?
Women get the sense that this is inevitable, that its a natural part of aging and they have to live with it, says Fairchild. This false perception leaves women feeling powerless, even though there are ways to greatly improve their quality of life.
To help overcome the stigma, Fairchild shared three facts about urinary incontinence that all women should know.
Urinary Incontinence In Women: What You Need To Know
Urinary incontinence is the accidental loss of urine.
Over 25 million adult Americans experience temporary or chronic urinary incontinence.
This condition can occur at any age, but it is more common in women over the age of 50.
There are four types of urinary incontinence: urgency, stress, functional and overflow incontinence.
Behavioral therapies, medications, nerve stimulation and surgery are some of the treatments available for managing urinary incontinence.
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Posterior Tibial Nerve Stimulation
Your posterior tibial nerve runs down your leg to your ankle. It contains nerve fibres that start from the same place as nerves that run to your bladder and pelvic floor. It is thought that stimulating the tibial nerve will affect these other nerves and help control bladder symptoms, such as the urge to pass urine.
During the procedure, a very thin needle is inserted through the skin of your ankle and a mild electric current is sent through it, causing a tingling feeling and causing your foot to move. You may need 12 sessions of stimulation, each lasting around half an hour, one week apart.
Some studies have shown that this treatment can offer relief from OAB and urge incontinence for some people, although there is not yet enough evidence to recommend tibial nerve stimulation as a routine treatment.
Tibial nerve stimulation is only recommended in a few cases where urge incontinence has not improved with medication and you don’t want to have botulinum toxin A injections or sacral nerve stimulation.
What Treatment Options Are Available If Urinary Incontinence Still Won’t Go Away
Seeing a urogynecologist as early as possible can help ensure that you have a complete understanding of your condition and treatments options.
“Both stress and urgency incontinence typically respond well to behavioral modifications, but if things are not improving, it’s best to get evaluated,” says Dr. Lindo. “This is why I always recommend seeing a specialist about your condition right away. You never want to play the guessing game with your health, especially when your condition affects your quality of life.”
In addition, your doctor can recommend a pelvic floor physical therapy program. While Kegels can play an important role in alleviating urinary incontinence, Dr. Lindo says they’re performed incorrectly more than 80 percent of the time.
“An incorrect Kegel will not help correct urinary incontinence,” warns Dr. Lindo. “Seeing a physical therapist who specializes in pelvic floor exercises can help ensure you’re performing Kegels and other exercises correctly and truly strengthening your pelvic floor.”
And if your condition continues to progress or worsen, your urogynecologist has expertise to perform testing and recommend a range of urinary incontinence treatment options and procedures that can help to correct your condition and address your specific situation.
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What Causes Incontinence
There are many different reasons that you could experience incontinence. These causes can vary depending on if youre a woman or man. Some causes are temporary health conditions that usually go away once treated. In those cases, your incontinence also usually stops once the condition is treated. Incontinence can be caused by long-term medical conditions. When you experience leakage issues because of a chronic condition, its usually something you will have to manage over a longer period of time. Even with treatment, chronic conditions usually dont go away. Incontinence may have to be managed over time as a symptom of your chronic condition.
Temporary or short-term causes of incontinence can include:
- Urinary tract infections : An infection inside your urinary tract can cause pain and increase your need to pee more often. Once treated, the urge to urinate frequently usually goes away.
- Pregnancy: During pregnancy, your uterus places extra pressure on the bladder as it expands. Most women who experience incontinence during pregnancy notice that it goes away in the weeks after delivery.
- Medications: Incontinence can be a side effect of certain medications, including diuretics and antidepressants.
- Beverages: There are certain drinks like coffee and alcohol that can make you need to urinate much more often. If you stop drinking these beverages, your need to urinate frequently typically goes down.
- Constipation: Chronic constipation can cause you to have bladder control issues.
When To See Your Doctor
Itâs time to get things checked out if:
- You have to go to the bathroom a lot more than usual, and often canât hold in your urine until you get to the toilet
- You leak when you sneeze, cough, or even stand up
- You leak at random times, even if you didnât cough or sneeze
- You feel like your bladder still has urine in it, even after you go
- Your stream of urine is weak
- You have to strain when you urinate
- It hurts to urinate
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Risk Factors For Urinary Incontinence
The following factors may put you at higher risk for developing UI.
Being female Women experience stress incontinence twice as often as men. Men, on the other hand, are at greater risk for urge and overflow incontinence.
Advancing age As we get older, our bladder and urinary sphincter muscles often weaken, which may result in frequent and unexpected urges to urinate. Even though incontinence is more common in older people, it is not considered a normal part of aging.
Excess body fat Extra body fat increases the pressure on the bladder and can lead to urine leakage during exercise or when coughing or sneezing.
Other chronic diseases Vascular disease, kidney disease, diabetes, prostate cancer, Alzheimer’s disease, multiple sclerosis, Parkinson’s disease, and other conditions may increase the risk of urinary incontinence
Smoking A chronic smoker’s cough can trigger or aggravate stress incontinence by putting pressure on the urinary sphincter.
High-impact sports While sports don’t cause incontinence, running, jumping, and other activities that create sudden pressure on the bladder can lead to occasional episodes of incontinence during sports activities.
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Should I Drink Less Water Or Other Fluids If I Have Urinary Incontinence
No. Many people with urinary incontinence think they need to drink less to reduce how much urine leaks out. But you need fluids, especially water, for good health.
Women need 91 ounces of fluids a day from food and drinks.11 Getting enough fluids helps keep your kidneys and bladder healthy, prevents urinary tract infections, and prevents constipation, which may make urinary incontinence worse.
After age 60, people are less likely to get enough water, putting them at risk for dehydration and conditions that make urinary incontinence worse.12
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How I Manage Incontinence And Bladder Control
What many refer to sarcastically as adult diapers became, and to this day are, one of my best friends. I wear adult underwear any time I step foot out my front door, and if I’m having a bad day in my house too. I don’t want any mishap on my furniture, or when my family or friend are visiting. When you have end-stage COPD incontinence becomes a regular occurrence. Whenever I go out I not only wear protective underwear, I also carry an extra pair and some feminine wipes with me. I keep them in a small zippered bag, if I lose control and pee my pants, as soon as I can I go to a restroom, clean up, and I’m good to go again. The best part is no one knows what has occurred but me, no embarrassment, no weird looks. I know a lot of people refuse to wear adult underwear, they feel there is a stigma attached. In their minds wearing adult underwear is undignified, unmanly or un-womanly. Don’t become one of them, there are all types of products for dealing with incontinence.
Editors Note: We are extremely saddened to say that on March 2, 2018, Mary Ultes passed away. Mary was an engaged advocate for the COPD community who strived to help people live fulfilling lives. She is deeply missed.
Is Incontinence More Common In Women
Incontinence is much more commonly seen in women than in men. A large part of this is because of pregnancy, childbirth and menopause. Each of these events in a womans life can lead to bladder control issues. Pregnancy can be a short-term cause of incontinence and the bladder control issues typically get better after the baby is born. Some women experience incontinence after delivery because of the strain childbirth takes on the pelvic floor muscles. When these muscles are weakened, youre more likely to experience leakage issues. Menopause causes your body to go through a lot of change. Your hormones change during menopause and this can alter your bladder control.
Men can also experience incontinence, but it isnt as common as it is in women.
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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.
How Can I Manage Incontinence At Home
Incontinence can be uncomfortable and disruptive. It can cause sleeping problems, make you feel ashamed or angry, or affect your daily life in other ways. In addition to working with your health care team to find the best treatment, there are things you can do at home to help make incontinence better or more comfortable.
Limit how much you drink, especially coffee and alcohol. Avoid foods that can irritate the bladder, including dairy products, citrus fruits, sugar, chocolate, soda, tea, and vinegar.
Go to the bathroom right before bedtime and any vigorous activity.
Wear an absorbent pad inside your underwear or disposable incontinence underwear.
Maintain a healthy weight. Extra weight can put pressure on the bladder and muscles that support it.
Go to the bathroom regularly each day. Do not wait too long or put off going.
Quit smoking. Nicotine can irritate the bladder. It can also make you cough and leak urine.
Do Kegel exercises. Ask your health care team about doing Kegel exercises at home. They can make your bladder stronger. To do Kegel exercises, first tighten the muscles you use to stop the flow of urine. Then, relax those muscles. Repeat the exercise several times. During this exercise, relax the muscles in your belly, buttocks, and thigh.
Finally, it can help to find support. Talk with your health care team or join a support group for people with bladder problems. It can help you feel better to know that other people are also dealing with incontinence.
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