Solutions For A Leaky Bladder
Research has found that at least half of people with urinary incontinence dont discuss the condition with a health care provider. But theres no need to feel embarrassed. If you have a leaky bladder, youre definitely not alone. Bladder leakage, or urinary incontinence, affects women and men of all ages, though it becomes more common later in life.
And its definitely worth discussing, because of the many ways it can interfere with enjoying daily lifefrom exercise and travel to social outings and romance, says E. James Wright, M.D., director of urology at Johns Hopkins Bayview Medical Center.
How Is It Diagnosed
Your physical therapist will perform a thorough exam. Their goal is to identify the causes of your urinary incontinence. They will ask you to describe your symptoms and your daily experiences, and will assess:
- The muscles of your pelvis, hips, and lower back.
- Your coordination, strength, and flexibility.
- Whether you have pain in your pelvic floor muscles.
Your physical therapist also may refer you to a doctor for more tests to aid in diagnosis. These may include:
- Urodynamic testing .
- Ultrasound or MRI to show any pelvic floor muscle problems.
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.
Also Check: How Common Are Bladder Infections
Xi Role Of The Funder
This project was completed under Contract No. HHSA 290-2015-00002-I from the Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services, through funds provided by a partnership with the Patient-Centered Outcomes Research Institute . The AHRQ TOO reviewed contract deliverables for adherence to contract requirements and quality. The authors of this report are responsible for its content. Statements in the report should not be construed as endorsement by PCORI, the Agency for Healthcare Research and Quality or the U.S. Department of Health and Human Services.
Eligibility Criteria For The Key Questions
The eligibility criteria for the update are not substantially different from the criteria for the 2012 AHRQ review. The main differences relate to dropping KQ 1 , explicitly adding subpopulations of interest, and making some criteria more explicit .
Changes from the 2012 AHRQ review include the following:
Based on stakeholder input, we will highlight four specific subpopulations of interest . Studies that either focus on these subpopulations or provide relevant subgroup data will be highlighted.
In addition, we will apply stricter rules about the exclusion criteria, allowing only up to 10 percent of study participants to be among the excluded populations the 2012 AHRQ review allowed up to 25 percent to be men. If we find studies that were included in the 2012 AHRQ review that included between 10 and 25 percent men, we will exclude these from the current review.
No changes are made from the 2012 AHRQ review.
All outcomes reported in the 2012 AHRQ review’s eligibility criteria are included in this update, except for urodynamic testing, which is used in practice only for diagnosis, not for followup outcome assessment. We will add patient-centered outcomes identified from the contextual question on how patients define outcome success.
Study design, Timing, Setting
No substantive changes are made from the 2012 AHRQ review.
|Unable to read or translate.|
You May Like: Where Does Bladder Cancer Usually Spread To
Try Pelvic Floor Therapy
Pelvic floor therapy is a type of specialized physical therapy that strengthens the muscles that support your bladder and bowels. This can be very effective in treating urinary incontinence caused by an overactive bladder.
During pelvic floor therapy, a physical therapist may lead you through exercises that target your pelvic floor, use mild electrical stimulation to help you have more awareness of your pelvic floor muscles, and use other specialized techniques. If youre interested in pelvic floor therapy, talk with a doctor about getting a referral.
Conducting The Systematic Review
Searching for the Evidence: Literature Search Strategies for Identification of Relevant Studies to Answer the Key Questions
To identify new primary research studies meeting our criteria we will conduct literature searches of studies in PubMed, the Cochrane Central Trials Registry, the Cochrane Database of Systematic Reviews, and EMBASE databases. We will also search the FDA Web site , ClinicalTrials.gov, and the International Clinical Trials Registry Platform. We will also review reference lists of existing systematic reviews for additional studies.
To the extent possible, the current search will replicate the search reported by the 2012 AHRQ review. However, we will add terms for any listed eligible interventions that were omitted from the 2012 AHRQ review search strategies. We will use the search strategies in Appendix A. Since the terms being added to the 2012 AHRQ review primarily cover interventions that were included in that review , we will not search for older studies with the newly added terms.
With the exception of studies in the 2012 AHRQ review, studies found from existing systematic reviews will be extracted de novo. For studies included in the 2012 AHRQ review, to the extent feasible, we will rely on their extraction and summary data for study level data, including risk of bias assessment.
Data Extraction and Data Management
Assessment of Methodological Risk of Bias of Individual Studies
Grading the Strength of Evidence
You May Like: Bladder Infection Versus Yeast Infection
Do Pelvic Floor Muscle Exercises
Strong pelvic floor muscles hold in urine better than weak muscles. You can strengthen your pelvic floor muscles by doing Kegel exercises. These exercises involve tightening and relaxing the muscles that control urine flow. Researchers found that women who received pelvic floor muscle training had fewer leaks per day than women who didnt receive training.6 You should not do pelvic floor exercises while youre urinating.
Men can also benefit from pelvic floor muscle exercises. Strengthening these muscles may help a man leak urine less often, especially dribbling after urination.
A health care professional, such as a physical therapist trained in pelvic floor therapy, can help you get the most out of your Kegel exercises by helping you improve your core muscle strength. Your core includes your torso muscles, especially the lower back, pelvic floor muscles, and abdomen. These muscles keep your pelvis lined up with your spine, which helps with good posture and balance. Your physical therapist can show you how to do some exercises during daily activities, such as riding in a car or sitting at a desk.
You dont need special equipment for Kegel exercises. However, if you are unsure whether you are doing the exercises correctly, you can learn how to perform Kegel exercises properly by using biofeedback, electrical stimulation, or both. Biofeedback uses special sensors to measure muscle contractions that control urination.
Bladder And Bowel Incontinence
Incontinence is a loss of control of a person’s bowels or bladder which can cause accidental leakage of body fluids and waste. Incontinence can be more than a physical problem. It can disrupt your quality of life if its not managed well.
Fear, anxiety, and anger are common feelings for people dealing with incontinence. You may avoid being intimate or having sex because you are afraid of urine, gas, or stool leakage. Fear of having an accident may keep you from being physically active, enjoying hobbies, or spending extended time outside your home.
Anyone can have incontinence during and after surgery or some other treatments for cancer. Incontinence can also occur because of other non-cancer medical conditions. Be sure to talk to your health care team if you have difficulty controlling urination or bowels. Talking about incontinence can be embarrassing, but being open and honest with your health care team can help manage it.
You May Like: Botox For Overactive Bladder Cost
From Leaking Urine To Sudden Urges To Go: An Ob
You dont have to suffer in silence there are many treatment options available.
Whether its a few drops of leaking urine or a complete emptying of the bladder, incontinence is a bladder control issue that women are twice as likely to have as men. And by the time a womanhas made an appointment to talk about what shes dealing with, she has had enough.
Incontinence can be embarrassing, super annoying, and costly. But you dont have to suffer in silence there are many treatment options available.
Choosing The Best Treatment
Treatment options have expanded rapidly over the last few years, making solutions much more feasible for women of all ages. These include:
For both stress and urge incontinence:
- Physical therapy Considered an effective and non-invasive treatment, physical therapy that includes techniques such as pelvic floor muscle exercise , bladder retraining and biofeedback can reduce or eliminate both stress and urge urinary incontinence in most women. Youll want to find a physical therapist specially trained in the area of incontinence ask your doctor for a referral. The physical therapist will create a treatment plan designed to meet your needs.
For urge incontinence:
For stress urinary incontinence:
- Vaginal devices Some devices, inserted vaginally, can help improve stress urinary incontinence without the risks of surgery. A pessary is a silicone ring inserted into the vagina by your doctor, similar to a vaginal contraceptive diaphragm. The pessary helps support the urethra to prevent leakage. It can remain in place long-term but needs monitoring by the doctor to avoid problems with vaginal abrasions.Another device, called Impressa®, can be inserted by a woman like a tampon to lift and give support to the urethra. It can reduce or prevent urine leaks for up to eight hours.
Also Check: Frequent Bladder Infections In Females
Absorbent Pads Catheters And Medical Devices
If medical treatments cant completely eliminate your incontinence, you can try products that help ease the discomfort and inconvenience of leaking urine:
- Pads and protective garments
- Pessaries and vaginal inserts a small device inserted into the vagina to help provide support to prevent leakage
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.
Read Also: How To Test For Bladder Infection
What Is Female Incontinence
Female incontinence is the loss of bladder control in women. It is not uncommon to lose urine during pregnancy or with urinary tract infections temporarily. There are many reasons you might develop urinary incontinence as a chronic problem. The most common causes are pelvic floor trauma with childbirth, menopause, hysterectomy, obesity, cognitive impairment, chronic cough and constipation.
There are three types of female incontinence:
- Urge incontinence: Women with urge incontinence feel the need to urinate frequently. They experience leakage of urine during times associated with this urge.
- Stress incontinence: Women with stress incontinence, also known as physical or exertion incontinence, may experience urine leakage, especially when coughing, laughing, exercising or sneezing.
- Mixed incontinence: Many women experience a combination of stress incontinence and urge incontinence.
When You Should See A Health Care Professional
You shouldnt have to wear a pad to soak up urine every day. Also ask yourself these questions:
Is the urge to urinate interfering with your work because of leaking or frequent bathroom breaks?
Do you map out where bathrooms are when you run errands?
Is incontinence interfering with your sex life or intimacy with your partner?
These are all signs of a problem, and that it may be time for you to talk with a gynecologist.
Recommended Reading: Why Do I Have Bladder Leakage
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.
Bladder Leakage Causes Symptoms & Treatments
Experience bladder leaks? Use this guide to understand the causes of bladder leaks, signs and symptoms, as well as tips to prevent or stop leaks.
Female bladder leakage occurs when the muscles around your bladder are weakened and canÃ¢t successfully close off the bladder as they should. If youÃ¢re experiencing a leaking bladder, know that youÃ¢re not alone. You likely have many questions, which is why we put together this guide to help you understand the causes of bladder leaks, the signs and symptoms, as well as tips to prevent or stop leaks.
Donât Miss: Cobra Medium Drain Cleaning Bladder
Also Check: Is Pumpkin Seed Oil Good For Overactive Bladder
There Are Different Types
If you experience incontinence when you sneeze, cough, or exercise, you may have stress incontinence, which is leakage from added pressure on the abdomen that pushes urine past the urethra.
If you stand up and are unable to hold off on emptying your bladder before you reach the bathroom, you may have urge incontinence, otherwise known as an overactive bladder.
Many women have a combination of stress and urge incontinence called mixed incontinence. And although less likely, some women experience overflow, a rare condition which causes frequent urinary leaks due to a constant full bladder.
Read Also: Stage 3 Bladder Cancer Life Expectancy
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.
You May Like: Why Do You Bleed When You Have A Bladder Infection
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
What Medications Can I Use For Overactive Bladder
Your doctor may suggest trying behavioral techniques before having you use a medication to treat overactive bladder. However, medications can work very well to return normal function to the bladder. Ask your doctor about the risks and benefits of using the following commonly prescribed medications:
These medications control muscle spasms in the bladder:
- Oxybutynin , oxybutynin XL , oxybutynin TDDS .
- Tolterodine .
- Mirabegron .
Also Check: Is Bladder Leakage Common After Hysterectomy
How Does Incontinence Relate To Age
Incontinence should not be considered to be a normal condition of aging. Elderly patients should be evaluated in essentially the same way that patients of any age should be evaluated. Incontinence is certainly more common as patients age, but incontinence can be seen in children, adolescents, and adults.
What Causes Overactive Bladder
An overactive bladder can be caused by several things, or even a combination of causes. Some possible causes can include:
- Weak pelvic muscles: Pregnancy and childbirth can cause your pelvic muscles to stretch and weaken. This can cause the bladder to sag out of its normal position. All of these factors can cause leakage.
- Nerve damage: Sometimes signals are sent to the brain and bladder to empty at the wrong time. Trauma and diseases can cause this to happen. These can include:
- Pelvic or back surgery.
Often, there may be no specific explanation for why this is occurring.
Also Check: What Happens With Bladder Cancer