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.
Lower Urinary Tract Symptoms
The lower urinary tract includes the bladder and the tube that urine passes through as it leaves the body .
Lower urinary tract symptoms are common as people get older.
They can include:
- problems with storing urine, such as an urgent or frequent need to pass urine or feeling like you need to go again straight after you’ve just been
- problems with passing urine, such as a slow stream of urine, straining to pass urine, or stopping and starting as you pass urine
- problems after you’ve passed urine, such as feeling that you’ve not completely emptied your bladder or passing a few drops of urine after you think you’ve finished
Experiencing LUTS can make urinary incontinence more likely.
Page last reviewed: 07 November 2019 Next review due: 07 November 2022
When To See A Doctor For Urinary Incontinence
In most cases, UI can be treated without surgery. If left untreated, UI can lead to sleep loss, depression, anxiety and loss of interest in sex. It might be a good idea to see your doctor if your condition is causing you to:
- Frequently urinate
- Feel tired from incontinence-related sleep loss
- Feel socially anxious about your urinary incontinence
- No longer participate in activities that bring you joy
- Miss out on big moments or lose productivity
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Fast Facts On Urinary Incontinence
- Urinary incontinence is more common in females than in males.
- There are a number of reasons why urinary incontinence can occur.
- Obesity and smoking are both risk factors for urinary incontinence.
Urinary incontinence is when a person cannot prevent urine from leaking out.
It can be due to stress factors, such as coughing, it can happen during and after pregnancy, and it is more common with conditions such as obesity.
The chances of it happening increase with age.
Bladder control and pelvic floor, or Kegel, exercises can help prevent or reduce it.
Treatment will depend on several factors, such as the type of incontinence, the patients age, general health, and their mental state.
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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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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
Take control of your bladder
Do you find yourself struggling to make it to the bathroom in time? Urinary incontinence is a common condition. Your doctor can help you understand whats causing it and recommend a treatment plan.
Lifestyle changes can also help get your bladder under control. Learn about six steps you can take to reduce your risk of accidents and help you get back to enjoying everyday activities, leak-free.
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How Is Incontinence Diagnosed
Often, the diagnosis process for incontinence will start with a conversation with your healthcare provider about your medical history and bladder control issues. Your provider might ask you questions like:
- How often do you urinate?
- Do you leak urine between trips to the toilet, how often does this happen and how much urine do you leak each time?
- How long have you been experiencing incontinence?
These questions can help your provider figure out a pattern with your leakage, which often points to a specific type of incontinence. When your provider is asking about your medical history, its important to list all of your medications because some medications can cause incontinence. Your provider will also ask about any past pregnancies and the details around each delivery.
There are also several specific tests that your provider might do to diagnose incontinence, including:
While at home, your provider might recommend you keep track of any leakage in a journal for a few days. By writing down how often you experience incontinence issues over the span of a few days, your provider might be able to identify a pattern. This can really help in the diagnosis process. Make sure to write down how often you need to urinate, how much you are able to go each time, if you leak between trips to the bathroom and any activities you might be doing when you leak urine. Youll then bring this journal with you to your appointment and talk about it with your provider.
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Other Urinary Incontinence Causes
Not all urinary incontinence is caused by hormonal changes. Leakage can occur as a result of several different factors, including:
- Obesity: Being overweight can lead to weakened pelvic floor muscles.
- Beverage Choices: Caffeinated and alcoholic beverages can cause frequent urination.
- Constipation: Your pelvic floor muscles can be weakened by chronic constipation.
- Infections: An infection in your bladder or urinary tract can cause UI as well as pelvic pain.
- Nerve Damage: Damage to nerves can mean your brain doesn?t receive signals indicating you need to urinate, leading to leakage.
- Medication Side Effects: Steroids and diuretics can cause frequent urination.
These factors can affect individuals of all ages but are relatively easy to address with medical treatment or lifestyle changes.
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Some Medical Conditions Can Contribute To Incontinence
Certain medical conditions can cause or contribute to incontinence. Often, these make symptoms more noticeable in people who might otherwise have had mild incontinence, says Eilber.
Poor muscle control, nerve damage, or excessive urine production, known as polyuria, can all make it difficult to hold your pee. These can be symptoms of underlying conditions like diabetes or kidney disease, or the side effects of medications.
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How To Get Incontinence Supplies Through Insurance
Follow these steps to see if you qualify to receive incontinence supplies covered by your insurance.
Why Does Urinary Incontinence Occur With Pregnancy
Pregnancy and childbirth can cause incontinence in several ways:
- Your growing baby takes up a lot of room. As the uterus expands, it puts increased pressure on the bladder, urethra, and pelvic floor muscles. This can lead to leakage.
- Changing progesterone levels during pregnancy can weaken the pelvic floor. Increases in this hormone loosen up your ligaments and joints so the belly can expand and so you can deliver. But it can also loosen ligaments in the pelvis that help you hold in urine.
- Childbirth, particularly vaginal delivery, can stretch and weaken the pelvic floor muscles. This can lead to pelvic organ prolapse, in which your bladder, uterus, or rectum droops into the vaginal canal. Prolapse can be associated with urinary incontinence.
- Vaginal delivery also can result in pelvic muscle and nerve injury, which can result in bladder control problems.
If you experience urinary incontinence during pregnancy, you are at higher risk of having a persistent problem after birth. Tell your health care provider about urinary incontinence symptoms as soon as you notice them during pregnancy or at your first postnatal visit.
More than 80% of postpartum women who experience SUI symptoms during pregnancy may continue to experience stress incontinence without treatment.
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Do Regular Kegel Exercises
Once you find your pelvic floor muscles, you can complete regular Kegel exercises to strengthen them. Simply contract your pelvic floor muscles, hold them for five to ten seconds, and relax them. The Urology Care Foundation suggests that you complete at least two sessions of Kegel exercises per day. Up to 30 contractions per session.
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What Steps Can I Take At Home To Treat Urinary Incontinence
Your doctor or nurse may suggest some things you can do at home to help treat urinary incontinence. Some people do not think that such simple actions can treat urinary incontinence. But for many women, these steps make urinary incontinence go away entirely, or help leak less urine. These steps may include:
You can also buy pads or protective underwear while you take other steps to treat urinary incontinence. These are sold in many stores that also sell feminine hygiene products like tampons and pads.
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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.
Answered By Female Pelvic Medicine Expert Jennifer Cera Dnp Aprn
A prolapse is not a dangerous medical condition, but it can cause discomfort, including a feeling of vaginal heaviness.
There are multiple causes of pelvic organ prolapse:
- Vaginal delivery
- Giving birth to babies greater than 9 pounds
- Having a forceps or vacuum-assisted delivery
- Having a long second stage of delivery
- Lifestyle factors such as smoking, frequent heavy lifting and obesity
Kegel exercises are an easy way to prevent pelvic floor problems. They also keep prolapses from getting worse. To properly perform Kegels, follow these steps:
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What Can I Do To Prevent Bladder Problems After Birth
There are some simple steps you can take during pregnancy to help prevent incontinence.
- Drink 6 to 8 cups of fluid a day, unless your doctor tells you otherwise. Avoid drinks containing sugar or caffeine, as these can irritate the bladder.
- Eat a high fibre diet with 2 pieces of fruit, 5 serves of vegetables and 5 serves of cereals/bread per day.
- Make sure you have a healthy weight.
- excessive twisting and turning activities
- exercises that require you to hold your breath
- exercises that require sudden changes of direction or intensity
- exercises that make you use one leg more than the other, or lifting your hip while you are on your hands or knees
- exercises that involve standing on one leg for a period of time
- activities involving sudden changes in intensity
- exercises that increase the curve in your lower back
Your Pelvic Floor Might Get Weak
When you force your bladder to constantly carry around a bowling ball’s worth of pee for hours, the muscles in your pelvic floor start to lose strength. “Pelvic floor muscles contract in a coordinated fashion to help you either release pee or hold it,” Streicher says. “But if you’re continually holding urine, you can end up with some real dysfunction of your pelvic floor muscles.” Over time, that can cause you to lose control of your bladder functions.
Don’t freak out if you feel the urge to go and your boss pulls you into her office for a quick brainstorming session when you were about to jet to the ladies’ room, or if you’re on a road trip and it’s an eternity till the next rest stop. “There’s a big difference between someone who holds it once in a blue moon and someone who does it all the time,” Streicher says. “Every now and then isn’t going to cause huge problems.”
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Find Your Pelvic Floor Muscles
Overactive bladder is one common cause of bladder control problems, especially among women. Doing regular Kegel exercises can help treat this condition. These exercises also called pelvic floor muscle exercises.
Kegel exercises are relatively easy to do. But before you can start, you need to find your pelvic floor muscles. The next time you urinate, try to stop your flow of urine midstream. The muscles you use to do that are your pelvic floor muscles.
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Treatments For Urgency Incontinence
Urgency incontinence is when you get the urge to go, and if you dont make it to a bathroom, your bladder will empty. It can have serious effects on your life and your work.
Experts dont know what causes urgency incontinence, but there are different ways to approach it. First we start with behavioral changes, which vary based on your situation. Steps could include:
Weight loss again, losing even a small amount of weight can help.
Avoiding excess fluids. If youre having trouble sleeping, we talk about limiting fluids before bedtime so sleep is less interrupted.
Time voiding, which is retraining the bladder. If the patient is in the bathroom every hour, well slowly lengthen that interval so theyre in the bathroom less often.
Pelvic floor exercises, with help from a physical therapist.
Changing your diet. I review a list of bladder irritants: coffee, chocolate, alcohol, spicy foods, and other things. We have patients skip those foods and drinks for a week or two and see what their urgency or frequency is like.
If behavioral changes dont help, there are other options to explore. We can try certain medications that relax your bladder muscles and prevent leakage. Botox, injected into the muscles of the bladder, can help some patients temporarily. And there are several medications we can try, including anticholinergics, which block the impulse to urinate. This can help you get more sleep at night.
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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.
Keeping A Bathroom Journal
You may be asked to keep a bathroom journal before or after your appointment. In your journal, youll log all your bathroom trips and bladder leakage or issues. It can also be helpful to record what you eat and drink in your bladder journal. This record will help your doctor get a more accurate idea of your symptoms and how often they occur. Keeping a journal can also determine what triggers your need to pee or any accidents.
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