But Do Recognize When Youre Drinking Enough
While you should drink plenty of fluids to stay hydrated, drinking to excess can certainly affect your bladder control. How do you walk that fine line?
I tell my patients to look at their pee color. If its light yellow or clear, they dont need to drink more, W. Stuart Reynolds, MD, MPH, associate professor in the department of urology at Vanderbilt University Medical Center, tells SELF. If their urine is dark yellow or orange, they need to drink more.
Remember, hydration doesnt just come from your water bottle. Soups, juices, and even certain foods contribute to your daily fluid intake as well, which can help your goals feel more realistic.
Types And Causes Of Incontinence In Aging Adults
Simply put, the bladder does two things: it stores urine and empties of urine.
When storage goes wrong, this can result in symptoms of urgency, frequency, and stress incontinence. When these symptoms are severe, like having to void more than 13 times a day, or more than twice at night, quality of life can be significantly impaired.
There can also be problems with getting the bladder to empty at the right time and place. Two types of issues that often come up for older adults are:
Heres a chart reviewing the different types of incontinence:
|A mixture of the above symptoms|
So far, Ive talked mostly about chronic incontinence, but there can be a few reasons why an older person would suddenly start losing bladder control. As a geriatrician, I always want to rule out these potentially treatable issues before embarking on a long-term continence management plan.
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When To Seek Medical Help
Any instance of incontinence is reason to seek medical help. It may be a symptom of a more serious condition that needs to be treated.
Even if the underlying cause isnt serious, incontinence can be a major disruption in your life. Its important to get an accurate diagnosis and discuss treatment options with a healthcare professional.
In some cases, incontinence can be a sign of a medical emergency.
You should seek immediate medical attention if you lose control of your bladder and experience any of the following symptoms:
- trouble speaking or walking
Urinary incontinence and treatment for urinary incontinence may result in complications, depending on the cause.
These complications may include:
- Urinary tract infections. UTIs can be caused by wet undergarments against the skin. This may create an environment where bacteria can grow.
- Kidney damage. In some cases where the flow of urine is obstructed, you may experience kidney trouble or kidney failure.
- Cellulitis. This skin infection is caused by bacteria and may cause swelling and pain.
- Medication side effects. Medications used to control urinary incontinence may cause side effects, depending on the medication. Side effects may include dry mouth, nausea, hypertension, or others.
- Catheter side effects. If you have a catheter placed, you may experience side effects such as infection and trauma.
- Mental health side effects. Urinary incontinence may cause feelings of anxiety, depression, or social isolation.
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How Is Loss Of Bladder Control Treated
Non-surgical treatments are often recommended to help treat bladder control issues. These include:
- Physical therapy and exercise
- Reducing intake of alcohol and caffeine
- Electrical stimulation of the nerves that control the bladder
- Bladder retraining by going to the bathroom at set times
- Kegel exercises to strengthen pelvic muscles
- Biofeedback to help patients learn to control the bladder muscles
Depending on the type of leakage and how bothersome it isand if patients do not respond to the non-surgical treatmentssurgery and other interventions can be very successful. In most cases, they can be done as an outpatient procedure.
Last reviewed by a Cleveland Clinic medical professional on 08/26/2015.
Symptoms Of Oab Your Browser Does Not Support Html5 Audio Playback You May Download The Audio File Directly Here
Urgency: This is the main symptom of OAB. It is a strong need to urinate that cant be ignored. This gotta go feeling makes people afraid that theyll leak urine if they dont find a bathroom right away. OAB may also cause:
- Incontinence : Sometimes OAB causes urine to leak out before getting to the bathroom. This is called urgency incontinence. Some people may leak just a few drops, while others can have a sudden gush.
- Urinate frequently: OAB may also cause people to go to the bathroom many times during the day. Experts say that frequent urination is when you have to go to the bathroom more than eight times in 24 hours.
- Wake up at night to urinate: OAB can wake a person from sleep to go to the bathroom more than once a night. This is called nocturia by health providers.
Some foods and drinks can bother the bladder. Caffeine, artificial sweeteners, alcohol, chocolate and very spicy foods may make OAB symptoms worse.
OAB does not cause pain. If you feel pain while urinating, you may have an infection. Please talk with your health care provider about pain.
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What Is Bladder Training
Bladder training involves going pee at set time intervals. For example, you might start by peeing every hour. If you need to urinate before the hour is up, you try to wait, using techniques like deep breathing to help. If you can’t wait, use the bathroom.
Gradually, you increase the time between bathroom trips, making your bladder more accustomed to holding a greater amount of urine. Eilber recommends increasing the time between urination by five minutes every week.
A small 2013 study found that bladder training led to decreased symptoms of overactive bladder and improved quality of life in adults with overactive bladder.
You should discuss your bladder training goal with your doctor, says Eilber.
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.
Incontinence A Big Problem For Young Women
Among teens and young women, incontinence problems are typically related to sports injuries, says Pamela Moalli, MD, a professor of urogynecology at the University of Pittsburgh Magee-Womens Research Institute. “About 20% of college athletes report leakage of urine during sports activities,” she tells WebMD.
“Women in high-impact sports are at highest risk — parachuters, gymnasts, runners,” says Moalli. “In these sports, you’re hitting the ground hard, which can damage pelvic muscles and connective tissue that support the bladder.”
Many young women have pre-existing biological reasons putting them at higher risk, says Niall Galloway, MD, FRCS, professor of urology and director of the Emory Continence Center at Emory University School of Medicine in Atlanta.
“It runs in families,” he tells WebMD. “Just as bad eyesight runs in families, so can weak pelvic muscles. It’s not that they’ve been overdoing it with exercise. It’s just that they’ve reached the tolerance of their own tissues.”
For these girls and women, simply wearing a tampon or pessary — a device similar to a diaphragm — during exercise is a good solution, says Galloway. “They just need a little something to support those pelvic tissues, something to put pressure on the urethra.”
How A Health Professional Can Help
The first health professional that youre likely to talk to about incontinence is your primary care provider, but they may refer you to another physician or professional who can better help. Urologists and gynecologists are surgeons who see men and women for incontinence, and nurse continence advisors can run specialized interprofessional clinics.
Diagnosing the cause of incontinence
What your doctor will ask about: The treatment of incontinence depends on the cause of the symptoms, which your doctor will evaluate by asking questions, doing a physical examination, and probably order a few preliminary investigations.
Your doctor will review your personal medical history, especially any history of prostate surgery for men, and for women, the history of any pregnancies and number and types of births. Lifestyle issues like smoking, alcohol intake, caffeine consumption, exercise , and body weight are likely to come up.
A careful review of the patterns of incontinence will help to determine the cause of urine loss.
To review, three common patterns of urinary incontinence are:
- Stress: if you lose urine when doing certain activities,
- Overflow: you lose urine all the time in a dribble,
- Urge: feeling an urgent need to get to the toilet that you sometimes cant meet,
In older adults, its common for there to be a mixture of more than one pattern .
Your doctor will want to know:
The physical examination
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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.
Consider Using A Pelvic Floor Training Device
If you just dont have access to a physical therapist right now, you can also consider trying a Kegel exercise trainer to help ensure youre targeting the right muscles. These devices are available online, so they may be easier to access than a pelvic floor PT, depending on any geographic and financial constraints you have. Some of them even provide feedback to help you improve.
A 2020 review of research that explored the effectiveness of app-based pelvic floor exercises and app-and-pelvic floor trainer combos found that using these tools helped improve urge incontinence control and helped people adhere to their exercise routines.2
A device is really handy if youre just starting out, Dr. Sutherland says, but she encourages people to ultimately work toward learning how to target these muscles without one.
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Living With Urinary Incontinence
Urinary incontinence does, unfortunately, become a long-term problem for some women. Here are some tips on living with it:
- use incontinence pads, which are made for urine leakage, rather than sanitary pads
- take a change of underwear or set of clothes when you go out
- know where toilets are located so you can find them quickly
- cross your legs when sneezing or laughing
- modify your exercise routine to avoid high impact exercises such as jumping
Coping With Incontinence: Lifestyle Changes
But for most women, a little absorbent pad is their first weapon, a lifestyle change their second.
For many women the change may be as simple as drinking less water.
“You can’t drink two big bottles of water at one time, because it comes through your system as one big of fluid,” says Brubaker. “If you have a little at a time, it’s much easier for the bladder.”
Perhaps you just need to urinate more frequently – especially before getting onto the tennis court, for example.
You may also simply learn to brace yourself when you laugh or cough, tightening your pelvic muscles to prevent leaks.
“Women are smart…” says Brubaker. “They try a bunch of things on their own before they get the gumption to talk to someone about it.”
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Alternative Treatments For Nocturia
Many people turn to complementary and alternative medicine before seeking medical help. You may also be interested in alternative medications or treatments for nocturia, but there are few studies to support their use. These treatments may work for nocturia, but only if OAB is the cause.
For example, research has found that:
- herbal medications have a positive impact on symptoms of OAB and quality of life
- acupuncture provides short-term relief for OAB symptoms
- homeopathic remedies may have benefits, but need more studies
- alternative treatments have fewer side effects than medications
- saw palmetto berry extract has no benefit for nocturia
But more research is needed to confirm if CAM works for OAB.
Always talk to your doctor before trying a supplement or alternative treatment. Certain CAM treatments can cause unintended side effects, especially if youre already taking medication.
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 Im having a bad day in my house too. I dont 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 Im 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. Dont 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.
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Surgical Treatments For Ui
Bladder control surgery to treat stress incontinence is available and works by giving more support to the urethra. The support keeps you from leaking when pressure is put on your bladder or your urethra, putting you in control of when its time to go. There are also procedures available to treat urge incontinence.
Our doctors will help to decide if a procedure or surgery is the best option for you and will walk you through how it works as well as answer any questions you may have.
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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Alternative And Complementary Therapies
The treatment of urinary incontinence varies depending on the cause of the bladder control problem. In most cases, a physician will try the simplest treatment approach before resorting to medication or surgery.
Bladder habit training This is the first approach for treating most incontinence issues. The goal is to establish a regular urination schedule with set intervals between urination. A doctor will usually recommend urinating at one-hour intervals and gradually increasing the intervals between urination over time.
Pelvic muscle exercises Also called Kegel exercises , this exercise routine helps strengthen weak pelvic muscles and improve bladder control.
The person contracts the muscles used to keep in urine, holds the contraction for 4 to 10 seconds, then relaxes the muscles for the same amount of time.
It may take weeks or months of regular pelvic exercise to show improvement.
Another way to perform Kegel exercises is to interrupt the flow of urine for several seconds while urinating.
Do You Pee When You Push The Baby Out
Labor and delivery, postpartum care Answer From Yvonne Butler Tobah, M.D. Most women are able to use the bathroom during labor to urinate and to have a bowel movement. Your health care provider will probably encourage you to do so because itâs possible that a full bladder might slow down your babyâs descent.
If medications are used, this is usually in combination with other techniques or exercises.
The following medications are prescribed to treat urinary incontinence:
- Anticholinergics calm overactive bladders and may help patients with urge incontinence.
- Topical estrogen may reinforce tissue in the urethra and vaginal areas and lessen some of the symptoms.
- Imipramine is a tricyclic antidepressant.
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