What Causes Bladder Leakage In Women
The three types of urinary incontinence and main causes of bladder leaking are:
- Stress incontinence
- Urge incontinence
- Overflow incontinence
Stress incontinence is the most common cause of bladder leakage in women and is the result of a weakened pelvic floor. The pelvic floor is the system of muscles and ligaments that form a basket of support for your bladder and uterus. The pelvic floor helps regulate the urinary sphincter, which controls the flow of urine out of the bladder. The pelvic floor can be weakened by life events such as pregnancy, childbirth or being overweight. Once weakened, any pressure â or stress â placed on the pelvic floor causes a small amount of urine to leave the bladder. This can be from coughing, laughing, sneezing, exercising or lifting objects.
Urge incontinence , also known as overactive bladder or OAB, is the result of nerve damage to the nerves in and around the bladder, either as a result of a neurological disease like multiple sclerosis or Parkinsonâs or due to previous pelvic surgery or injury. This nerve damage means that the nerves and muscles in your bladder spasm and fire off too often, sending you on a mad dash to the bathroom. This means that your bladder signals that itâs time to go even when itâs not full. The urge to urinate then comes on suddenly and intensely, to the point that you often may not make it to the toilet in time to urinate.
Control Your Urge To Urinate
You may be able to control, or suppress, the strong urge to urinate, which is called urge or urgency suppression. With this type of bladder training, you can worry less about finding a bathroom in a hurry. Some people distract themselves to take their minds off needing to urinate. Other people find that long, relaxing breaths or holding still can help. Doing pelvic floor exercises to strengthen your pelvic floor also can help control the urge to urinate. Quick, strong squeezes of the pelvic floor muscles can help suppress urgency when it occurs, which may help you get to the toilet before you leak.
It Could Be A Sign Of An Underlying Condition
Naturally, later in life, people can experience incontinence because of increased production of urine related to aging kidneys. Bladder function is also heavily impacted by changing bladder capacity and chronic medical conditions like diabetes, says Fairchild. Chronic straining, coughing and/or constipation can all put stress on the bladder, she explains.
But leakage can also be sign of a more serious, underlying health condition, according to a 2018 National Poll on Healthy Aging.” For example, poor heart function could be the culprit behind frequent urination while sleeping.
If fluid is pooling in your legs during the day, when you lay down, that fluid redistributes and increases urine production, says Fairchild.
Although bladder leakage is common, discuss your particular symptoms with your doctor.
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At Balance Within Integrative Physical Therapy Weve Created A 3 Step Process To Get Rid Of Your Leakage And Make Sure It Doesnt Come Back Again
Step #1 – We Want To Listen To Your Story
Our medical system is frustrating. You wait weeks, sometimes months, for an appointment, only to get to talk to the doctors for 10 minutes before they have to run to the next patient and youre left sitting there wondering, What just happened?Even most physical therapy clinics operate this way. Theyre not attentive, theyre fast-paced, and your therapist doesnt have time to actually hear about whats important to you or to work with you one-on-one. Thats why we operate so differently! And thats why our first step is to listen to your story.After working with lots of people with Overactive Bladder and Bladder Control issues, we know that no two people are alike. Each person has a different body, a different history, and different types of incontinence .That is why our first step is to have an open conversation and time for you to tell your story. That way we get a deep understanding of whats going on not just with your body, but also how its impacting your life.
Step #2 – FIND OUT WHY YOUR LEAKAGE STARTED
Many people have a diagnosis, or medical term for whats going on with their body. Maybe their doctor gave it to them, maybe tests showed the diagnosis, or maybe you found it online.
Step #3 – GET RID OF THE LEAKAGE & KEEP IT FROM COMING BACK
When Nerve Damage Causes Bladder Problems: Neurogenic Bladder
Until a few short years ago, Rob, who is in his 80s, had been relatively free of health problems. He was an active guy, skiing and hiking in his beloved Washington State mountains. Husband, father and grandfather, he was living a happy retirement from Boeing Aircraft. Then what he thought was a small nagging problem was diagnosed as a complex medical problem.
When ongoing heartburn was keeping him awake at night, he went to a GI doctor for help. A scan showed Robs bladder was so enlarged it was pushing against his stomach, causing the heartburn. One doctor visit after another revealed more than one medical issue. Rob began a series of tests and surgeries to treat bladder cancer, prostate cancer and an aortic aneurysm.
His cancers were removed, but nerve damage from his surgery left Rob unable to fully empty his bladder. Today, he relies on using a straw-like tube, called a catheter, to help empty his bladder completely. Rob has neurogenic bladderand he isnt alone. Millions of Americans have this health issue. Neurogenic bladder is when a person lacks bladder control due to damage to the nerves carrying messages between the bladder and the brain. This damage may be the result of a spinal cord injury, an infection of the brain or spinal cord, heavy metal poisoning or diseases affecting the nerves, such as stroke, multiple sclerosis, Parkinsons disease or diabetes. People born with problems of the spinal cord, such as spina bifida, are also at risk for neurogenic bladder.
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Pelvic Floor Muscle Exercises
Also known as Kegel exercises, these exercises are especially effective for stress incontinence but may also help urge incontinence. To do pelvic floor muscle exercises, imagine that youre trying to stop your urine flow. Then:
- Tighten the muscles you would use to stop urinating and hold for five seconds, and then relax for five seconds.
- Work up to holding the contractions for 10 seconds at a time.
- Aim for at least three sets of 10 repetitions each day.
What Are Kegel Exercises
Kegel exercises, also called Kegels or pelvic floor muscle training, are exercises for your pelvic floor muscles to help prevent or reduce stress urinary incontinence. Your pelvic floor muscles support your uterus, bladder, small intestine, and rectum.
Four in 10 women improved their symptoms after trying Kegels.9 Kegels can be done daily and may be especially helpful during pregnancy. They can help prevent the weakening of pelvic floor muscles, which often happens during pregnancy and childbirth. Your pelvic floor muscles may also weaken with age and less physical activity.
Some women have urinary symptoms because the pelvic floor muscles are always tightened. In this situation, Kegel exercises will not help your urinary symptoms and may cause more problems. Talk to your doctor or nurse about your urinary symptoms before doing Kegel exercises.
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Other Types Of Bladder Leakage
- Mixed Incontinence: This label is given to bladder leakage conditions that stem from more than one form of incontinence, whether stress, urge, functional, or overflow. Women can be often diagnosed with stress and urge incontinence at the same time.
- Transient Incontinence: A transient incontinence refers to a temporary condition of a bladder leakage. It is often seen with complications after surgery, an irritated bladder, chronic constipation, and as a side effect of some diuretic and sleep-induced medication.
- Total Incontinence: A total loss of bladder function is referred to as total incontinence. This may be a result of nerve or bladder damage or disease that hinders the regular functioning of the bladder. Some cases of multiple sclerosis and spinal cord injuries may see a malfunction of the bladder to store urine.
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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Treatment Options For Stress Incontinence:
- Pelvic floor physical therapy This can improve up to 75% of symptoms.
- Pessary This device, inserted in the vagina, helps control leakage by providing support under the urethra and bladder.
- Urethra bulking This office-based procedure can help thicken the wall of your urethra so it more tightly seals to hold urine.
- Sling urethral surgery This outpatient surgery stops urine leakage via a sling that lifts and supports your urethra and lower bladder.
“If stress incontinence is severe, sling urethral surgery is typically about 95 percent successful and there’s very little down time as far as returning to everyday activities,” says Dr. Lindo.
What Happens As Your Hormones Start To Decrease
Our hormones naturally decrease as we age , and for women, this decrease is what leads to menopause. The thing is, hormone decline can also result in incontinence.
The decrease in your hormones leads to your vaginal tissue becoming thinner and less elastic. On top of that, your muscles start to weaken including the pelvic floor muscles that help you control of your bladder. See the connection?
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Will Urinary Incontinence Go Away On Its Own
There’s no doubt that urinary incontinence affects your quality of life. Leakages can not only irritate your skin and cause embarrassment, but constantly worrying about when one might happen next can keep you from living your life. So much so that you might plan everything you do around whether there’s a bathroom nearby.
It’s a very common problem affecting up to one in three women. If you’re experiencing urinary incontinence, you’re likely looking for answers. Specifically, what can you do to stop it?
“Urinary incontinence is a loss of urine when you’re not actively trying to urinate,” explains Dr. Fiona Lindo, urogynecologist at Houston Methodist. “It can happen without you being aware or with physical exertion, such as exercise or even when simply standing up, coughing or laughing.”
“Unfortunately, urinary incontinence isn’t likely to go away on its own. The good news, however, is that there are things that you can do on your own to improve it, and there are plenty of options for treating it,” adds Dr. Lindo.
How Can A Man Prevent Urine Leakage After Urination
How is it treated?
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What Kind Of Incontinence Are You Dealing With
There are several different types of bladder leaks. The two most common types of bladder leaks are stress incontinence and urge incontinence, according to Dr. Michael Ingber, a urologist who is board certified in female pelvic medicine and reconstructive surgery at The Center for Specialized Womens Health.
How Is Urinary Incontinence Treated
You and your doctor or nurse will work together to create a treatment plan. You may start with steps you can take at home. If these steps do not improve your symptoms, your doctor or nurse may recommend other treatments depending on whether you have stress incontinence or urge incontinence or both.
Be patient as you work with your doctor or nurse on a treatment plan. It may take a month or longer for different treatments to begin working.
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How Does Being Overweight Affect The Urinary System
When a person becomes overweight, fat tissue surrounds the bladder in both men and women. This fat tissue can push on the bladder, reducing its capacity. In turn, this makes it harder for a person to hold their urine until they get to a bathroom.
The more obese a person is the greater pressure placed on the bladder by the surrounding fat tissue. This loss of control over urination becomes increasingly worse as a person becomes more obese.
Secondly, it is important to define incontinence. According to the National Association for Continence , incontinence is defined as involuntary leakage of urine occurring when a person has the urge to urinate.
There are three different types of incontinence: overactive bladder, stress urinary incontinence , and mixed urinary incontinence .
Overactive bladder is described as having an urgent or frequent need to urinate. This type of incontinence can be caused by either bladder spasms or an overactive bladder muscle.
Stress urinary incontinence is leakage that happens when a person is exposed to something that increases pressure within the abdominal cavity, such as coughing, sneezing, or lifting something.
Obesity poses a serious threat to the health of both men and women, especially when it comes to urinary incontinence.
Obesity increases the risk of developing an overactive bladder, which is caused by an increased amount of pressure placed on the bladder by surrounding fats.
Neurogenic Bladder Treatment Outcomes
The success of any treatment for neurogenic bladder depends upon the underlying problem and how severe it is.
- Behavioral therapy: Exercises to strengthen the pelvic floor muscles can improve the control of urination in 56 to 95 percent of cases. Pelvic floor exercises, along with biofeedback, are successful in 54 to 87 percent of cases. Bladder training improves urine control in 75 percent of cases, with only 12 percent completely cured of urinary incontinence.
- Medication: The success of medical treatments depends upon the drug and dosage that is administered. Anticholinergic drugs were successful in treating incontinence in 13 to 90 percent of cases, and some antispasmodic drugs have been shown to cure incontinence in up to 50 percent of cases, although at times they may reduce symptoms in up to 90 percent of cases.
- Surgery: Bladder augmentation has been shown to be an effective way to increase the bladder’s ability to store urine. However, one study found that 41 percent of patients had at least one complication after the procedure. Use of an artificial urinary sphincter has been found to improve symptoms of incontinence in up to 95 percent of cases, with total control of urination in 86 percent of cases.
References
Staskin DR, Comiter CV. . Surgical procedures for sphincteric incontinence in the male: artificial genitourinary sphincter and perineal sling. Campbell-Walsh Urology. 10th ed.
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Living With Bowel Incontinence
You can help manage bowel incontinence by following a bowel care plan and using the toilet before you leave home. You can also make sure you carry your medications, supplies, fecal deodorants, and a change of clothes with you.
Anal discomfort, itching, and irritation can be common. Here are some ways to help manage these symptoms:
- Wash the anal area after a bowel movement or use baby wipes.
- Use a moisture-barrier cream in the anal area.
- Use wick pads or disposable underwear.
- Change soiled underwear frequently to keep the anal area clean and dry.
When It Comes To Solving Something Life
You must choose the right provider for your health. If you dont, you could end up getting surgery , depending upon pills to manage of your symptoms, or risking things progressing from pads to full out Depends in the future.
Getting the least-invasive, most natural treatment is VITAL to you stopping bladder control issues and keeping it from ever coming back.To do that, you have to not just treat the symptoms, but have a provider who is willing to figure out WHY the incontinence happened in the first place. Thats when youll get a PERMANENT solution to your problems.
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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.