What Causes Bladder Control Problems

Different Types Of Incontinence

There are four basic types of incontinence: stress, urge, overflow and functional. They may occur alone, or in combination, especially in seniors.

Stress incontinence is the involuntary leakage of small amounts of urine in response to increased pressure on the bladder . It is present in about 35 per cent of incontinent seniors. It is more common in women, often because childbirth caused the pelvic muscles to relax. It also occurs, usually temporarily, in men who have had prostate surgery.

Urge incontinence is the leakage of large amounts of urine when someone is unable to reach the toilet after getting the urge to urinate. It accounts for 60-70 per cent of incontinence problems in seniors.

Overflow incontinence accounts for 10-15 per cent of urinary incontinence. It occurs when there is an obstruction in the bladder, which causes the bladder to overfill. Often, there is no sensation that the bladder is full. Then, when the bladder contracts, urine is released.

Functional incontinence accounts for 25 per cent of the incontinence seen in institutions. It often happens because a person has difficulty moving from one place to another. Poor vision, hearing or speech may interfere with reaching the toilet or telling caregivers of the need to use the toilet. This type of incontinence can also occur in the home.

Treatments For Urinary Incontinence

For women who are experiencing bladder control issues, a few simple lifestyle changes can help to minimize leakage. If episodes of incontinence tend to occur at certain times of the day, be mindful of the time and plan trips to the bathroom to avoid accidents. If certain foods and drinks cause a noticable increase in the frequency of urination, try avoiding them. A food diary can help pinpoint which ingredients are the culprits. Achieving a healthy weight, not smoking and regularly performing kegel exercises to strengthen pelvic floor muscles can all help to minimize symptoms of urinary incontinence.

Dont be embarrassed to talk with a doctor about incontinence. They will perform urinary incontinence testing to help determine the underlying cause of the leakage and recommend a personalized treatment plan. Treatment could include any of the lifestyle changes above, prescription medication to calm an overactive bladder, or a device worn in the vagina that helps lift and support the bladder. In severe cases that do not respond to these treatments, surgery may be necessary to improve bladder control.

What Are Home Remedies For Bladder Control Problems

Incontinence is never normal. If you have a problem with urine leakage, you should see a medical professional.

While waiting for your appointment, make yourself more comfortable.

• Avoid foods and drinks that may irritate the bladder. These include alcohol, caffeine, carbonated drinks, chocolate, citrus fruits, and acidic fruits and juices.
• Do not drink too much fluid 6-8 cups a day is adequate, but you may need more if you are exercising, sweating a lot, or the weather is hot. In people with kidney stone disease, voiding at least 2 liters of fluid per day is important. Fluid restriction may lead to stone growth or formation.
• Urinate regularly.
• Do not ignore the urge to urinate or to have a bowel movement.
• If you are overweight, try to lose weight and reach a healthier weight.
• If necessary, wear absorbent pads to catch urine.
• Maintain proper hygiene. This will help you feel more confident and will prevent odors and skin irritation.

Kegel exercises: Exercising the muscles of your pelvic floor may benefit women with either stress or urge incontinence.

Create a urination diary. Take notes every day on your urination patterns. This will help your health-care provider in diagnosing your problem:

• Time of urge to urinate
• Strength of pain or urge
• Time you actually urinated
• Amount of leakage
• Type and amount of fluids you drink and when you drink them

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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
• Bladder control device inserted into vagina that repositions urethra to reduce leakage
• 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.

References

Treatment For Different Types Of Urinary Incontinence

Lifestyle changes and treatments can help with symptoms. Your doctor can help you come up with a plan thatâs right for you.

For stress incontinence, treatments include:

Pads and Vaginal Inserts.

Pelvic floor exercises. If you’ve had a baby, chances are you’ve been told to do Kegel exercises. These help to strengthen the pelvic floor after childbirth. They also help prevent stress incontinence. Best of all, you can do Kegels anytime, anywhere.

Here’s how:

Note: You can learn how to do Kegels by stopping your urine, but donât do this routinely. Stopping the flow of urine can lead to an infection.

Biofeedback. A probe is inserted to monitor when your bladder muscles squeeze. When youâre able to recognize it as it’s happening, you can start to gain control of it. It’s often used in combination with Kegel exercises.

Pessary. For women, doctors may prescribe a device called a pessary that is inserted into the vagina. It repositions the urethra to help reduce leakage.

Injections and surgery. Shots to bulk up your urethral area may help. In more extreme cases, you may need surgery. One procedure pulls the urethra back up to a more normal position, relieving the pressure and leakage. Another surgery involves securing the urethra with a “sling,” a piece of material that holds up the urethra to prevent leakage.

Pads.

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Bladder Control Problems Caused By An Overactive Bladder

There are also things that can cause the bladder to become overactive. Your doctor may check whether you have a bladder or urinary tract infection, which can cause pain and burning when urinating along with increased urination frequency.

Drinking alcohol is also known to make some folks bladder more active, as are a number of medications. When discussing your bladder issues with your healthcare professional, be sure to tell him or her about any medicines you take as well as the frequency with which you consume alcohol.

After the life events of pregnancy and childbirth, both risk factors for what are usually temporary bladder control problems, come menopause for women and prostate gland enlargement in men. Both of these life milestones are thought to increase a persons risk for bladder issues, although the specific physiology is unknown. Aging can also affect bladder function as the tissues in the lower urinary tract weaken.

As the risk factors associated with bladder control, such as pregnancy and childbirth, menopause, enlargement of the prostate gland, and aging affect nearly everybody in the United States, it is no surprise that nearly fifty percent of women and thirty percent of men will experience bladder control problems over the course of their lifetimes.

What Are The Different Types Of Bladder Control Loss

• Stress incontinence is caused by sudden pressure on the bladder. Exercise, sneezing, laughing, or heavy lifting may be just a few reasons for urine leakage. Younger and middle-aged women near or at menopause experience this most commonly.
• Urge incontinence happens when you are unable to hold on when you have an urge to urinate and cannot make it to the toilet. People with diabetes, stroke, MS, Alzheimers, and Parkinsons disease may have this problem.
• Overflow incontinence happens when the bladder is constantly full and cannot be completely emptied. An enlarged prostate blocking the urethra or a spinal cord injury may cause this condition.
• Functional incontinence may occur if you have a condition that prevents you from getting to the toilet in time. Arthritis or other disorders can keep you from being able to move quickly.

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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
• Pregnancy
• Hysterectomy

How Soon After Starting Kegel Exercises Will Urinary Incontinence Get Better

It may take 4 to 6 weeks before you notice any improvement in your symptoms.10

Kegel exercises work differently for each person. Your symptoms may go away totally, you may notice an improvement in your symptoms but still have some leakage, or you may not see any improvement at all. But even if your symptoms dont get better, Kegel exercises can help prevent your incontinence from getting worse.

You may need to continue doing Kegel exercises for the rest of your life. Even if your symptoms improve, urinary incontinence can come back if you stop doing the exercises.

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Menopause And Your Urinary Tract

It has been debated whether the changes in a womans urinary tract with age are due to menopause and the lack of estrogen, or instead related to the aging process alone. We do know, however, that the bladder is loaded with estrogen receptors, so the reduction of estrogen that happens in menopause probably doesnt help.

With age, the bladder begins to lose both its volume and its elasticity, and its normal to have to go to the bathroom more frequently. As the bacteria concentration in your genital region increases your urethra may thin, allowing bacteria easier access to your bladder. For these reasons, urinary tract infections are more common as women age. This risk begins to increase within four or five years of your final menstrual period.

The bladder also begins to thin, leaving women more susceptible to incontinence, particularly if certain chronic illnesses or recurrent urinary tract infections are also present.

The pelvic muscles weaken as you age. You may find that exercise, coughing, laughing, lifting heavy objects, or performing any other movement that puts pressure on the bladder can cause small amounts of urine to leak. Lack of regular physical exercise may also contribute to this condition.

What Is Urinary Incontinence Symptoms Causes Diagnosis Treatment And Prevention

Urinary incontinence , the involuntary loss of urine, is a very common condition that no one wants to talk about. Because of the stigma that surrounds it, many people are too humiliated to seek help. But most conditions that cause UI can be corrected with medical or alternative interventions.

Occurring much more often in women than men, UI happens when the muscles in the bladder that control the flow of urine contract or relax involuntarily, resulting in leaks or uncontrolled urination. UI itself is not a disease, but it can be a symptom of an underlying medical issue.

Recommended Reading: How Long Should A Bladder Infection Last

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.

Forms Of Urinary Incontinence That Affect Men Only

• Benign prostatic hyperplasia affects about 50 percent of men over the age of 60, and 90 percent over the age of 85 an enlarged prostate can cause sudden and frequent urges to urinate.
• Peyronies disease is the result of injury or damage to penile tissue, causing an abnormal curvature.
• Painful inflammation of the prostate gland

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What Is The Medical Treatment For Bladder Control Problems

Treatment depends of the type and severity of the incontinence. Many of these treatments require a commitment on your part to master the technique and practice it daily. Discuss all of the treatment options with your health-care provider before making a decision together.

Some medications that you may take for other medical conditions can cause incontinence. Review your medications with your health-care provider. If a medication is causing the problem, an alternative may be available.

Urge incontinence: Treatment is focused on eradicating the underlying cause. If your health-care provider is unable to identify a reversible cause, the focus of treatment becomes reducing symptoms. Treatment may include the following:

• Providing a commode or urinal for urination “emergencies”
• Limiting fluid intake
• Behavioral therapy: Changing your habits to try to reduce incontinence
• Timed voiding and bladder training regimens: Gradually prolonging the time between urination
• Pelvic floor exercises: To strengthen the sphincter muscles
• Pelvic floor electrical stimulation: Painless electrical pulses applied via a small probe in the vagina or rectum to increase tone of the pelvic floor muscles
• Medications: To relax the bladder or tighten the sphincter muscles

No matter what type of incontinence you have, medical treatment can take some time to take effect. During treatment, or if medical treatment does not work for you, you have the following alternatives:

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.

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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.

Treatment For Incontinence And Continence Problems

If you have incontinence or continence problems, you should seek help. There is a range of management options available. The treatments depend on the type of incontinence you have and what you hope to achieve.An incontinence management plan will usually include several of:

• adequate fluid intake of up to two litres each day
• incontinence aids such as pads, condom drainage or catheters.

Recommended Reading: Bowel And Bladder Problems After Back Surgery

Why Uti Is The Most Common Bladder Problem In Seniors

UTIs are one of the most common bladder problems among seniors. It is caused due to bacteria and there are several other reasons too for developing the risk of UTIs in older ones, such as:

• Having or had an UTI before
• Changes in the immune system
• Being exposed to various bacteria in the care facility or in hospital
• Presence of a urinary catheter
• Experiencing changes in the functionality of the urinary system
• Having health conditions such as Parkinsons disease, Alzheimers disease, diabetes, etc.

Bladder Control Problems And The Prostate

The prostate is a gland found only in men. It is about the size of a walnut and is located below the neck of the bladder, surrounding the bladder outlet or urethra. Because the prostate gland is located close to the outlet of the bladder, it is common for problems with the male prostate gland to also affect urinary processes.Urinary problems which start in middle age are often caused by the prostate gland getting larger as a man ages and partially blocking the flow of urine through the urethra as it leaves the bladder. This causes a condition called benign prostatic hyperplasia . Other causes of prostate-related urinary conditions include prostatitis or prostate cancer.

Read more about common prostate conditions

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