What Causes Weak Bladder Control

When Should I See A Health Care Professional

Female Bladder Leakage: Solutions to Get Control | Christopher Tarnay, MD | UCLAMDChat

See a health care professional if you have symptoms of a bladder problem, such as trouble urinating, a loss of bladder control, waking to use the bathroom, pelvic pain, or leaking urine.

Bladder problems can affect your quality of life and cause other health problems. Your health care professional may be able to treat your UI by recommending lifestyle changes or a change in medicine.

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.

Medications That Can Cause Urinary Incontinence

Urinary incontinence, or the loss of bladder control, can be caused by various health conditions and physical changes, such as childbirth, changes in diet, infection, prostate issues, menopause, and neurological disorders. But there are also a number of medications can cause urinary incontinence in both men and women in a variety of different ways.

Medication
Diuretics such as hydrochlorothiazide , furosemide , bumetanide , triamterene with hydrochlorothiazide	Increase urine production by the kidney	Frequent urination, overactive bladder, stress incontinence
Muscle relaxants and sedatives such as diazepam , chlordiazepoxide , lorazepam	Cause sedation or drowsiness relax the urethra	Frequent urination, stress incontinence, lack of concern or desire to use the toilet
Narcotics such as oxycodone , meperidine , morphine	Cause sedation or drowsiness relax the bladder, causing it to retain urine	Lack of concern or desire to use the toilet, difficulty in starting urinary stream, straining to void, voiding with a weak stream, leaking between urinations, frequency incontinence
Antihistamines such as diphenhydramine and chlorpheniramine	Relax the bladder, causing it to retain urine	Overflow incontinence
Alpha-adrenergic antagonists such as terazosin , doxazosin	Relax the muscle at the outlet of the bladder	Leaking when coughing, sneezing, laughing, exercising, etc.

From Better Bladder and Bowel Control, Harvard Health Publishing

Image: Thinkstock

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Treatment For Stress Urinary Incontinence

It is important to have your symptoms assessed by a health professional who will assess your bladder behaviour and pelvic floor and confirm that you have stress urinary incontinence.

The main treatment for stress incontinence is pelvic floor exercises. Surgery to tighten or support the bladder outlet can also help. Medication may be used in addition to exercises if you do not want, or are not suitable for surgery.

There is medication available for treating women with moderate to severe stress urinary incontinence, along with pelvic floor muscle exercises. Older people with other problems in addition to their bladder may benefit from seeing a specialist in medicine for older people.

How Is Neurogenic Bladder Treated

Bladder training: A non-surgical approach helps patients learn the skills and exercises needed to strengthen the pelvic floor muscles. Some patients might be asked to keep a diary recording the time of urination and amount passed, so the patient can establish a more manageable pattern for urination.
Catheterization: In this treatment, patients are taught how to self-insert a small catheter tube in order to empty the bladder at regular intervals.
Sacral Neuromodulation: In this relatively new approach, small electrodes and a stimulator are inserted near nerves related to bladder function. The stimulator delivers the electrical impulses that the body would normally receive if the nerves were undamaged.

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Urinary Incontinence: More Common Than You Think

How to Stop Urinary Incontinence

Urinary incontinence is the involuntary and unintentional leaking of urine. Urinary incontinence can also be an embarrassing problem. As with many potentially embarrassing or uncomfortable symptoms, those affected may be hesitant to speak up or ask questions about their condition, even at the doctors office. Urinary incontinence occurs more often in women than in men, and it is a lot more common than you might expect. In fact, chances are that you know other people who have been affected by urinary incontinence.

Incontinence must not be a source of embarrassment when you speak with your physician. The fact is that this common condition is treatable by a variety of approaches, and not speaking up about the problem means that you wont have access to effective treatments:

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Millions of women experience involuntary loss of urine called urinary incontinence . Some women may lose a few drops of urine while running or coughing. Others may feel a strong, sudden urge to urinate just before losing a large amount of urine. Many women experience both symptoms. UI can be slightly bothersome or totally debilitating. For some women, the risk of public embarrassment keeps them from enjoying many activities with their family and friends. Urine loss can also occur during sexual activity and cause tremendous emotional distress.

Stress Incontinence

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

Bladder training. This involves urinating according to a schedule. Your provider makes a schedule from you, based on information from your bladder diary. After you adjust to the schedule, you gradually wait a little longer between trips to the bathroom. This can help stretch your bladder so it can hold more urine.

Doing exercises to strengthen your pelvic floor muscles. Strong pelvic floor muscles hold in urine better than weak muscles. The strengthening exercises are called Kegel exercises. They involve tightening and relaxing the muscles that control urine flow.

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

Medical devices, including

A catheter, which is a tube to carry urine out of the body. You might use one a few times a day or all the time.

Bulking agents, which are injected into the bladder neck and urethra tissues to thicken them. This helps close your bladder opening so you have less leaking.

What Causes A Weak Bladder

Stress incontinence is usually caused by a weakening of the pelvic floor muscles or the urethral sphincter, which is a muscle that controls the opening and closing of the bladder.

Weakness of the pelvic floor muscle may come from damage or weakness after vaginal childbirth delivery, increasing weight, or age.

Pregnancy and childbirth can contribute to a weak bladder in many ways. During childbirth, there is an increase in weight from the pregnant womb on the bladder and on the pelvic floor that subsequently has to support both the bladder and the pregnant uterus.

As you can imagine, with constant heavy weight and stretching, the pelvic floor can become weakened. The pregnant uterus can also displace the urethras position in relation to the bladder , making this passage of urine from bladder to the outside more difficult.1 In addition, if an episiotomy is performed, this may also weaken the pelvic floor.

Therefore, after childbirth, it is more difficult for the pelvic floor to support the bladder well, and it does not form a tight seal around the bladder opening to keep urine in when its needed.2 This can lead to leaks of urine, particularly when the pressure in the abdomen increases at times of coughing, laughing, or sneezing.

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What Else Causes Bladder Control Problems In Women

Overactive Bladder, Causes, Signs and Symptoms, Diagnosis and Treatment.

Certain life events and health problems can lead to stress incontinence in women by weakening the pelvic floor muscles

pregnancy and childbirth

Weak pelvic floor muscles can make it hard for your bladder to hold urine in during stress incontinence. Stress incontinence occurs when an actioncoughing, sneezing, laughing, or physical activityputs pressure on your bladder and causes urine to leak. A weak pelvic floor can also cause fecal incontinence, or bowel control problems.

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Treatment Of Urinary Incontinence

Treatment usually begins with bladder training and Kegel exercises. Avoiding physical stresses that cause loss of urine and losing weight may help control incontinence. Pseudoephedrine may be useful in women with bladder outlet incompetence. Imipramine may be used for mixed stress and urge incontinence Urge incontinence Urinary incontinence is involuntary loss of urine. Incontinence can occur in both men and women at any age, but it is more common among women and older people, affecting about 30% of older women read more or for either separately. Duloxetine is also used for stress incontinence. If stress incontinence is caused by atrophic urethritis or vaginitis, estrogen cream is often effective. For people with stress incontinence, urinating frequently to avoid a full bladder is often helpful.

For stress incontinence that is not relieved with drugs and behavioral measures, surgery or devices such as pessaries may be helpful. The vaginal sling procedure creates a hammock of support to help prevent the urethra from opening during coughing, sneezing, or laughing. Most commonly, a sling is created from synthetic mesh. Mesh implants are effective, but a few people with mesh implants have serious complications. Alternatively, doctors can create a sling using tissue from the abdominal wall or leg. In men with stress incontinence, a mesh sling or an artificial urinary sphincter implant may be placed around the urethra to prevent leakage of urine.

What Causes Overactive Bladder

An overactive bladder can be caused by several things, or even a combination of causes. Some possible causes can include:

Weak pelvic muscles: Pregnancy and childbirth can cause your pelvic muscles to stretch and weaken. This can cause the bladder to sag out of its normal position. All of these factors can cause leakage.
Nerve damage: Sometimes signals are sent to the brain and bladder to empty at the wrong time. Trauma and diseases can cause this to happen. These can include:
Pelvic or back surgery.

Medications, alcohol and caffeine: All of these products can dull the nerves, which affects the signal to the brain. This could result in bladder overflow. Diuretics and caffeine can cause your bladder to fill rapidly and possibly leak.

Infection: An infection, like a urinary tract infection , can irritate the bladder nerves and cause the bladder to squeeze without warning.

Excess weight: Being overweight places extra pressure on your bladder. This can lead to urge incontinence.

Estrogen deficiency after menopause: This hormonal change could contribute to a loss of urine due to urgency. Ask your doctor if vaginal-only estrogen therapy is right for you. This is different from systemic hormone therapy, which is absorbed throughout the body.

Often, there may be no specific explanation for why this is occurring.

How To Get Help For Female Urinary Incontinence

Still feeling unsure about your first step? Remember, incontinence doesnt have to stop you from enjoying daily life on your terms. Getting the right diagnosis and treatment can be a life changer.

If you think that you might have urinary incontinence, reach out to one of our primary care doctors. Well answer any questions you may have and guide you to treatment that will work for you. If specialty care is needed, well refer you to our team of compassionate urogynecology specialists.

How Is Urinary Incontinence Treated

11 Fixes For A Weak Bladder (With images)

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.

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How Do I Control Urges When Resetting My Bladder

Controlling your urges is a key step in resetting your bladder. The following strategies may help:

Stop what youre doing and stay put. Stand quietly or sit down, if possible. Remain as still as possible. When youre still, its easier to control your urges.
Squeeze your pelvic floor muscles quickly several times . Dont fully relax in between Kegels.
Relax the rest of your body. Take several deep breaths to help you let go of any tension.
Concentrate on suppressing your urge to pee.
Wait until the urge goes away.
Walk to the bathroom at a normal pace. Dont rush. Continue squeezing your pelvic floor muscles quickly while you walk.

Patience is important. Retraining your bladder usually takes at least six to eight weeks to see results. Talk to a healthcare provider if you have any questions or arent happy with your progress. They may prescribe medications for you to take while youre resetting your bladder to help you achieve the best outcome.

Try To Prevent Constipation

Constipation causes the colon to swell and strain because of increased abdominal muscle pressure. This can adversely affect the bladder muscles and may also increase the frequency and severity of OAB symptoms.

Eating more fiber, getting regular exercise, and staying hydrated can help prevent constipation. In addition, there are certain yoga poses including the Crescent Lunge, Cobra, and Legs up the Wall that can help relieve constipation and promote healthy bowel movements.

Those who experience chronic constipation should talk with a doctor to learn more about other ways to help manage their constipation more effectively, such as by taking medications or trying physical therapy.

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Causes And Risk Factors

Aging

OAB occurs in both men and women. Its possible to have overactive bladder at any point in your life. But, its especially common in older adults. The prevalence of OAB in people younger than 50 years of age is less than 10 percent. After the age of 60, the prevalence increases to 20 to 30 percent.

The following are some of the other most common underlying causes and risk factors associated with OAB symptoms:

Nerve Damage

A healthy, normal functioning bladder holds urine until it gets full and is prompted to empty by nerve signals. However, when nerve damage occurs in the body, the muscles surrounding the urethra can be too loose. This undesirable looseness can cause someone to become incontinent. What can cause nerve damage that can then lead to bladder leakage? Some possibilities include:

Back or pelvis surgery

Weak pelvic muscles

When a man or womans pelvic floor muscles are weak, bladder control issues can happen. The pelvic floor muscles are like a sling that holds up the uterus and bladder. For women, a pregnancy and childbirth can often lead to a stretching and weakening of the vital pelvic floor muscles. When pelvic floor muscles are compromised for this reason or another, the bladder can then sag out of place. The opening of the urethra also stretches and urine easily leaks out.

Menopause

Is There Surgery For Bladder Control Problems

Physical Therapy Bladder Control Exercises for Men

Surgery for urinary incontinence either corrects an anatomical problem or implants a device to alter bladder muscle function.

Most people do not need surgery, but most of those who have surgery become dry.
Like any surgery, these procedures do not work on everyone. A small number of people are not completely dry after surgery.
Like all surgery, these operations can have complications.
Each of these procedures is appropriate only for a certain type or types of incontinence.
A urogynecologist or urologist can advise you about which, if any, might work for you.

Types of operations used in people with incontinence include the following:

Altering the position of the bladder neck, which can change how urine is released from the bladder
Repairing or supporting severely weakened pelvic floor muscles
Removal of a blockage
Implantation of a sling around the urethra
Implantation of a device that stimulates the nerves to increase awareness of the need to urinate
Injection of a naturally occurring material called collagen around the urethra
Injection of Botox into the bladder muscle using a cystoscope
Surgical placement of an artificial urinary sphincter
Enlargement of the bladder

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How Do I Take Care Of Myself

If treatments dont work for you, or if youre waiting for them to take effect, incontinence products such as disposable pads or adult diapers can help you take control and improve your quality of life.

The following can help boost your comfort and confidence if youre wearing incontinence products:

Change the product regularly. Changing your pads or adult diapers after a leak helps reduce odors.
Apply a barrier ointment or lotion. Using a barrier ointment or lotion on your skin before using incontinence products helps prevent skin irritation from regular exposure to pee.
Wear comfortable, loose-fitting clothes. Incontinence products can be bulky and make you feel self-conscious. Comfortable, loose-fitting clothing can help hide incontinence products, so you worry less about others noticing what youre wearing.
Wear darker clothing. Darker clothing helps hide any leaks that may occur.

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