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.
Causes Of Urge Incontinence
The urgent and frequent need to pass urine can be caused by a problem with the detrusor muscle in the wall of the bladder. The detrusor muscles relax to allow the bladder to fill with urine, then contract when you go to the toilet to let the urine out.
Sometimes the detrusor muscle contract too often, creating an urgent need to go to the toilet. This is known as having an ‘overactive bladder’. The reason your detrusor muscle contracts too often may not be clear, but possible causes include:
- drinking too much alcohol or caffeine
- poor fluid intake this can cause strong, concentrated urine to collect in your bladder, which can irritate your bladder and cause symptoms of overactivity
- conditions affecting the lower urinary tract , such as urinary tract infections or tumours in the bladder
- neurological conditions
- certain medications
Medication For Stress Incontinence
If stress incontinence does not significantly improve, surgery for urinary incontinence will often be recommended as the next step.
However, if you are unsuitable for surgery or you want to avoid having an operation, you may benefit from a medication called duloxetine. This can help increase the muscle tone of the urethra, which should help keep it closed.
You will need to take duloxetine by mouth twice a day and will be assessed after two to four weeks to see if the medicine is beneficial or if it is causing any side effects.
Possible side effects of duloxetine can include:
- nausea
- constipation
Do not suddenly stop taking duloxetine as this can also cause unpleasant effects. Your GP will reduce your dose gradually.
Duloxetine is not suitable for everyone, however, so your GP will discuss any other medical conditions you have to determine if you can take it.
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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.
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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Causes Of Total Incontinence
Total incontinence occurs when your bladder cannot store any urine at all. It can result in you either passing large amounts of urine constantly, or passing urine occasionally with frequent leaking.
Total incontinence can be caused by:
- a problem with your bladder from birth
- injury to your spinal cord, which can disrupt the nerve signals between your brain and your bladder
- a bladder fistula, which is a small tunnel-like hole that can form between the bladder and a nearby area, such as the vagina, in women
Am I At A Higher Risk Of Incontinence At An Older Age
Your body constantly changes throughout your life. As you age, the muscles that support your pelvic organs can weaken. This means that your bladder and urethra have less support often leading to urine leakage. Your risk for developing incontinence as you age might be higher if you have a chronic health condition, have given birth to children, went through menopause, have an enlarged prostate or have had prostate cancer surgery. Its important to talk to your healthcare provider over time about the risks of incontinence and ways you can manage it without interference to your daily life.
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Who Is Most At Risk
In addition to the causes mentioned above, there are some things that can increase your risk of developing urinary incontinence without directly being the cause of the problem. These are known as risk factors.
Some of the main risk factors for urinary incontinence include:
- family history there may be a genetic link to urinary incontinence, so you may be more at risk if other people in your family have experienced the problem
- increasing age urinary incontinence becomes more common as you reach middle age and is particularly common in people over 80
- having lower urinary tract symptoms a range of symptoms that affect the bladder and urethra
Take Preventative Measures Against Urinary Tract Infections
Incontinence is one symptom of urinary tract infection . Another symptom is a stinging or burning sensation when you pee and a decreased or irregular flow of urine. If you experience this, you should visit your doctor. UTIs are treated with antibiotics for 3 to 7 days.
Ways to prevent UTIs include:
- Drink plenty of water
- Urinate before and after having sex
- Wipe from front to back after you pee
- Wear breathable, natural underwear and clothing, changing your underwear daily
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Do Pelvic Floor Exercises Make A Difference
It takes time, effort and practice to become good at pelvic floor exercises/Kegels. It is best do these exercises for at least three months to start with. You should start to see benefits after a few weeks. However, it often takes two to five months for most improvement to occur. After this time you may be cured of stress incontinence. If you are not sure that you are doing the correct exercises, ask a doctor, physiotherapist or continence advisor for advice.
If possible, continue exercising as a part of everyday life for the rest of your life. Once incontinence has gone, you may only need to do one or two bouts of exercise each day to keep the pelvic floor muscles strong and toned up and to prevent incontinence from coming back.
What If These Treatments Do Not Work
These treatments should bring relief to most people who have urinary incontinence. However, if the treatments do not work for you, many absorbent protective pads are available to use. In men, a special sheath, known as a condom catheter, may be worn around the penis to drain the urine into a bag.
Sometimes, a tube called an in-dwelling catheter may be placed into the bladder to drain urine continuously. This method can cause problems, such as infections, and should be used only in special cases as a permanent form of treatment. Another approach is to use a catheter several times a day to drain the bladder.
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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.
Natural Treatments For Male Incontinence
Along with medications, your doctor will recommend lifestyle changes to help reduce male incontinence. By controlling the number of fluids you drink, and when you drink them, you can help control the urge to go.
It is best to drink smaller amounts of liquid at regular intervals during the day. You can also start bladder training by delaying when you use the bathroom. By gradually making your bladder wait, you strengthen its muscles and reduce incontinence. There are also exercises you can do to strengthen the pelvic floor muscles and those in the urinary tract system.
Urinary incontinence cannot always be prevented because you do not have control over certain risk factors like age and neurological conditions. There are lifestyle changes you can make that will help reduce the risk and help treat the problem, should it arise.
Not smoking or quitting Cutting back on alcohol and caffeine Being more active and losing weight Prevent constipation with a diet full of fiber
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When Should I See A Doctor About Incontinence
Its important to know that incontinence can be treated. Many people believe that its something that just goes along with aging and is an unavoidable issue. If you find that incontinence is disturbing your daily activities and causing you to miss out on things you typically enjoy, talk to your healthcare provider. There are a wide range of options to treat incontinence.
Addressing Odor Concerns When You Have Incontinence
Incontinence on its own can be a huge problem form many people. While bladder leaks might not seem like a big deal to some, those who deal with it on a regular basis know the trials someone with incontinence has to live with. The constant changing of clothes, finding products that will help you stay dry, dealing with the embarrassment that comes from having to wear protection or having an accident. And, of course theres the issue of odor.
Odor is a big concern among those with bladder leaks. But there are ways to prevent it, and treat it if you do happen to notice a smell. Read our tips below to learn how to kick odor to the curb.
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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.
The Squeeze & Release
The squeeze and release is your secret weapon towards getting your pelvic muscles to respond quickly. This can be very helpful for stopping leaks in pinch!To squeeze and release:
- Sit or stand in a comfortable position and think of the muscles used to control your urine flow.
- Squeeze your pelvic muscles as quickly as possible and rapidly release them with no attempt to hold the position.
- Take a rest for 5 to 10 seconds.
- Repeat contracting your pelvic muscles for 10 to 20 reps.
- Perform this exercise 3 times throughout the day.
Recently weve focused a number of blog posts on womens bladder and pelvic health issues, such as pelvic organ prolapse, UTIs and female leakage. Since then, weve received an overwhelming number of questions asking how to perform pelvic exercises to strengthen the pelvic floor. Keeping this organ, muscle and skeletal system healthy is essential for women of all ages.
Our guest blogger Lacey Savage, who is a licensed physical therapist at INTEGRIS Jim Thorpe Outpatient Clinics and an expert on pelvic floor dysfunction, answers your questions.
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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 canât successfully close off the bladder as they should. If youâre experiencing a leaking bladder, know that youâre 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.
Urinary Incontinence In Older Adults
Urinary incontinence means a person leaks urine by accident. While it may happen to anyone, urinary incontinence is more common in older people, especially women. Incontinence can often be cured or controlled. Talk to your healthcare provider about what you can do.
What happens in the body to cause bladder control problems? The body stores urine in the bladder. During urination, muscles in the bladder tighten to move urine into a tube called the urethra. At the same time, the muscles around the urethra relax and let the urine pass out of the body. When the muscles in and around the bladder dont work the way they should, urine can leak. Incontinence typically occurs if the muscles relax without warning.
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What Are The Risk Factors For Leaking Urine
Each type of incontinence can happen for different reasons, but there are some universal factors that can make incontinence more likely. According to MedlinePlus, adults are more likely to develop urinary incontinence if they:
Having a birth defect that affects the structure of your urinary tract can also raise your risk. Your risk is also higher if a close family member has urinary incontinence, especially urge incontinence, per the Mayo Clinic.
Many times, people with no risk factors can experience urinary incontinence. “Almost 70% of urge incontinence is idiopathic, meaning we don’t know what causes it to happen in otherwise perfectly healthy people,” says Dr. Sheyn.
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.
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Causes Of Urinary Incontinence
Stress incontinence is usually the result of the weakening of or damage to the muscles used to prevent urination, such as the pelvic floor muscles and the urethral sphincter.
Urge incontinence is usually the result of overactivity of the detrusor muscles, which control the bladder.
Overflow incontinence is often caused by an obstruction or blockage in your bladder, which prevents it from emptying fully.
Total incontinence may be caused by a problem with the bladder from birth, a spinal injury, or a small, tunnel like hole that can form between the bladder and a nearby area .
Certain things can increase the chances of urinary incontinence, including:
- pregnancy and vaginal birth
Find out more about the causes of urinary incontinence.
Best Treatment For Bladder Leaks
Recent research strengthens the link between incontinence drugs and dementia risk. Here’s how to find relief.
Drugs for an overactive bladder are promised to curb frequent bathroom breaks and bladder leaks.
But is taking medicationsmost of them members of a class of drugs called anticholingericsreally the best solution for regaining control of your bladder?
Anticholinergics commonly cause mental confusion, especially in older adults, and have, in the past, been linked to an increased risk of dementia.
Now, a large analysis from the U.K., published last week in the journal BMJ, has found that anticholinergic drugs, especially those used for bladder problems, Parkinsons disease, and depression, are associated with a higher likelihood of dementia in older adults even 20 years after use.
While this class of medications has long been known to be linked to memory troubles, it was not known whether the effects were permanent, says Michael Hochman, M.D., an associate professor of clinical medicine at the Keck School of Medicine at the University of Southern California. But this study suggests that the effects may not entirely reverse after stopping the medication.
The research doesnt prove that the drugs cause dementiaonly that there is an association between the two. However, this study does raise concerns, and anticholinergic medications for incontinence have several other well-established side effects, Hochman says.
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