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.
Take Care Of Your Skin
There are several reasons for that. To keep harmful bacteria at bay, skin is slightly acidic, but when urine touches flesh, skin becomes moist and more alkaline.
The result is an inviting environment for bacteria and yeast , which can lead to rashes and infection.
Prevention can be simple:
- Check your skin daily, looking for rashes or other signs of irritation. Be sure to separate and check any skin folds, too.
- Wash carefully after every accident, using mild soaps or perineal washes additionally, avoid hot water, which can make irritated skin even worse.
- To avoid skin tears and even more irritation, let skin air-dry don’t rub.
- Apply a cream, ointment, or film-forming skin protectant regularly to help keep urine away from tender skin.
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.
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Pads And Other Urinary Incontinence Products For Daily Leaking
A simple yet effective way to manage a leaky bladder is to wear a protective pad or liner during the day.
There are specific pads available for bladder leakage, which are different than the ones youd wear during menstruation. For example, Poise Ultra Thin pads have thin, protective layers that are made specifically to absorb urine.
Results are fairly immediate but these devices arent for everyone, specifically those with pelvic infection, vaginal ulcerations, allergy to product materials, or those who cannot commit to using them regularly.
Disposable inserts, which are like tampons, are another way to prevent leakage. Poise makes one called Impressa.
There are also reusable underpants that are similar to disposable pads, but you can wash and wear them multiple times.
What Can You Do To Relieve Urinary Incontinence
Urinary incontinence almost never goes away on its own. But there are steps you can take to help relieve your symptoms.
“Alleviating urinary incontinence starts with understanding which type of incontinence you’re experiencing and what’s causing it,” says Dr. Lindo. “A specialist such as a urogynecologist can help provide those answers for you, as well as help you understand which behavior modifications and other treatments will be most effective for alleviating your incontinence.”
Weight loss almost always helps relieve urinary incontinence because it reduces the amount of pressure being placed on your pelvic floor. In fact, losing just 5 percent of your weight can improve your urinary symptoms by up to 70 percent.
Similarly, pelvic floor exercises, such as Kegels, can help reduce symptoms of either type of incontinence. In the case of stress incontinence, pelvic floor exercises are a way to restrengthen your weakened muscles. For urge incontinence, these exercises can help calm and retrain your bladder.
“For women experiencing stress incontinence after childbirth, sometimes weight loss and postnatal pelvic floor exercises are all it takes for symptoms to resolve over time,” adds Dr. Lindo.
Depending on the type of incontinence you’re experiencing, your doctor may suggest trying additional modifications.
Behavioral modifications for stress incontinence:
- The use of a vaginal insert, such as a tampon, while exercising
Behavioral modifications for urgency incontinence:
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What Are The Possible Complications Of Bladder Surgery
There can be complications of bladder surgery. You are at higher risk if you are over the age of 60 or designated female at birth. Possible problems include:
- Gastrointestinal problems: Abdominal surgeries can interfere with your bowel functions. Talk to your healthcare provider about how to handle GI issues.
- Reproductive health in men: Bladder cancer can spread to your prostate. During bladder surgery, your prostate may also be removed, which may impact your fertility.
- Reproductive health in women: If your uterus is removed as part of bladder cancer surgery, you won’t be able to get pregnant.
- Urinary diversion: If you have a procedure that reroutes your urine , you may have complications. Pee could leak from the opening made in your body, and there could be an infection.
- Hormonal changes: If your bladder cancer has spread to your ovaries, they may need to be removed. Menopause will begin.
- Inability to urinate: Some people, especially women who have had more than their bladder removed, are unable to pee right away. This usually lasts no longer than a week. Youll be given a catheter and a leg bag . Your healthcare provider will teach you how to operate the equipment.
What Are The Treatments For Urinary Incontinence
Treatment depends on the type and cause of your UI. You may need a combination of treatments. Your provider may first suggest self-care treatments, including:
- Lifestyle changes to reduce leaks:
- Drinking the right amount of liquid at the right time
- Being physically active
- Staying at a healthy weigh
- Avoiding constipation
If these treatments do not work, your provider may suggest other options such as:
- Medicines, which can be used to
- Relax the bladder muscles, to help prevent bladder spasms
- Block nerve signals that cause urinary frequency and urgency
- In men, shrink the prostate and improve urine flow
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When Should You See A Doctor For Leaking Urine
Incontinence is common but not normal, says Sapienza. “I think suffer in silence thinking that they can’t get help, but it is treatable,” she says.
Some patients aren’t concerned with a few leaks here or there, and if it’s truly not bothering you, then you likely don’t need to see anyone, says Dr. Sheyn.
However, if you’re altering your life in order to manage symptoms, then talk to a doctor. For instance, maybe when you go to a new place, you immediately scout out a bathroom to make sure you know where to dash off to if the time comes. Or maybe you decline invitations out because you can’t be sure of the bathroom situation. Maybe you live in black leggings to hide urine leaks, something that patients often tell Sapienza they do.
You should also talk to your doctor if you’re leaking urine frequently. Besides the impact it can have on your social, work, and personal relationships, regular urinary incontinence can also lead to physical complications like skin problemsrashes, skin infections, and sores can develop from constantly wet skinand urinary tract infections. There’s this too: Chronic incontinence might be a sign of a more serious underlying condition, and that’s something you’d want to get checked out.
Reduce Your Fluid Intake
Drinking water is good for your body, and its important to stay hydrated, but overdoing fluid intake can lead to bladder urgency and leaks. The key to healthy fluid intake is maintaining a good balance. Try to drink water when thirsty, but not more of it than your body asks for. And keep an eye on the color of your urine. If its clear, you could probably cut back on fluid intake, but dark urine is a sign that you need more fluids.
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Tips To Keep Your Bladder Healthy
People rarely talk about bladder health, but everyone is affected by it. Located in the lower abdomen, the bladder is a hollow organ, much like a balloon, that stores urine. Urine contains waste and extra fluid left over after the body takes what it needs from what we eat and drink. Each day, adults pass about a quart and a half of urine through the bladder and out of the body.
As people get older, the bladder changes. The elastic bladder tissue may toughen and become less stretchy. A less flexible bladder cannot hold as much urine as before and might make you go to the bathroom more often. The bladder wall and pelvic floor muscles may weaken, making it harder to empty the bladder fully and causing urine to leak.
While you cant control everything that affects your bladder, here are 15 steps you can take to keep it as healthy as possible:
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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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.
What Are Other Symptoms Of Urinary Incontinence
Besides the already-mentioned hallmark symptoms of each type of incontinence, the National Institute of Diabetes and Digestive and Kidney Diseases says that other symptoms might include:
- Leaking urine without any warning or urge
- Wetting your bed while sleeping
- Leaking urine while having sex
Another symptom of urinary incontinence is urinating oftenmore than seven times per day or more than once at nightsays Dr. Sheyn.
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Who Gets Incontinence
Incontinence can happen to anyone. However, its more common in certain groups and at certain times in your life. Incontinence is much more common in women than in men. This is often related to pregnancy, childbirth and menopause. Each of these experiences can cause a womans pelvic support muscles to weaken over time.
Youre also more likely to experience incontinence as you get older. The muscles that support your pelvic organs can become weaker over time, causing you to experience leakage issues.
When To Consider Meds
If you have urge incontinence and have tried nondrug measures for several months but symptoms are still interfering with your quality of life, you might consider adding medication.
There is a role for these drugs, Hochman says, but typically only after trying safer treatments first.
How do they work? In some people with urge incontinence, the bladder muscles contract at the wrong time, causing the uncomfortable feeling of urgency and often leaks. Drugs used to treat the condition relax the bladder muscles, which can increase the storage size of the bladder and reduce the urge to urinate.
Based on analysis of the evidence by CR Best Buy Drugs, none of the drugs clearly works better than the others.
If you and your doctor conclude that one is worth trying, consider generic prescription extended-release oxybutynin. It costs about twice as much as the short-acting drug if youre paying out-of-pocket but offers the convenience of once-a-day dosing.
In addition, research suggests that it has a somewhat lower risk of side effects than other forms of the drug, including the OTC patch, as well as some other bladder drugs, including short-acting tolterodine.
Watch closely for side effects, particularly memory problems or confusion, which can be subtle, Hochman says. Because of those risks, our experts advise against the drugs for anyone diagnosed with dementia.
If symptoms havent improved after eight weeks, ask your doctor about adjusting the dose or trying a different option.
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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.
How Is Leaking Urine Diagnosed
Your doctor will have to determine the type of urinary incontinence you have.
Starting a few days ahead of your appointment, your doctor might ask you to keep a bladder diary, MedlinePlus says. The diary would track how much and when you drink liquids, when and how much you urinate, and whether you leak urine.
During the appointment, your doctor will ask about your medical history and symptoms and perform a physical exam. This might include a rectal exam and, for women, a pelvic exam. They might also have you cough or do some other simple maneuver that can initiate the leaking.
To make a diagnosis, your doctor might also run some tests, including:
- Urine and/or blood tests
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What Happens Before Bladder Surgery
Your healthcare provider may recommend you stop taking any medications that risk bleeding during your bladder surgery. You should stop the following medications about a week before:
- Acetylsalicylic acid .
Some antibiotics, blood pressure medications and herbal medications or supplements may also be restricted. Youll also be asked to stop smoking and using tobacco products. Besides the negative health consequences that smoking has, tobacco use can lead to higher risks both during and after surgery. Tobacco has been proven to slow down the healing process and decrease the effectiveness of the immune system.
Dont discontinue any medication without your healthcare providers instruction.
Your provider will likely recommend you change your diet the day before your surgery and follow a clear liquid diet starting the morning before your surgery. This includes juices without pulp, soup broth and Jell-O. Its also important to arrange for someone to care for you after surgery as returning to normal activity is not recommended immediately.