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
Tips To Get Your Bladder Under Control
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.
Is Incontinence More Common In Women
Incontinence is much more commonly seen in women than in men. A large part of this is because of pregnancy, childbirth and menopause. Each of these events in a womans life can lead to bladder control issues. Pregnancy can be a short-term cause of incontinence and the bladder control issues typically get better after the baby is born. Some women experience incontinence after delivery because of the strain childbirth takes on the pelvic floor muscles. When these muscles are weakened, youre more likely to experience leakage issues. Menopause causes your body to go through a lot of change. Your hormones change during menopause and this can alter your bladder control.
Men can also experience incontinence, but it isnt as common as it is in women.
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Why Is It So Difficult To Talk About Bladder Control
Millions of men and women suffer from loss of bladder control. Bladder incontinence is twice as common in women because pregnancy, childbirth and menopause can affect pelvic muscle strength and damage nerves that control the bladder.
Many people feel embarrassed or ashamed to talk about their bladder control problems, yet many effective treatments are available. Your doctor may not ask about urinary function during an exam, so you should speak up if you are struggling with bladder control issues.
What Is Urinary Incontinence
Urinary incontinence is the loss of bladder control. In children under age 3, its normal to not have full bladder control. As children get older, they become more able to control their bladder. When wetting happens in a child who is old enough to control his or her bladder, its known as enuresis. Enuresis can happen during the day or at night. Enuresis can be frustrating. But its important to be patient and remember that its not your childs fault. A child does not have control over enuresis. And there are many ways to treat enuresis and help your child.
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After Giving Birth To Her Daughter Sharon Had Very Slow Urine Flow And Pain Tests Showed A
The problem started, it would be 22 years ago when I gave birth to my daughter, after I had her I couldnt wee, so I had an indwelling catheter. I had that in for a day and it was taken out and I started weeing normally, painful but slow.
Was that a natural delivery? How long did it take you to pass urine? And pain at the end?
After a lot of tests and investigations, some of the women we spoke to were diagnosed with Fowlers Syndrome, the commonest cause of urinary retention in young women. Urinary retention in young women is not common but can be quite debilitating. It is caused by the sphincters failure to relax and allow urine to be passed normally. The urethral sphincter is the muscle that closes the urethra and keeps people continent. No neurological disorder is associated with Fowlers Syndrome: up to half the women also have polycystic ovaries.
Newly Published Swan Research Shows That Urinary Incontinence Is Problematic For Many Women Over 40
Women who experience leakage from their bladders or have the got to go feeling at inconvenient times are not alone, a new study out of UC Davis shows. The problem, though embarrassing for some, is more common and treatable than many women realize.
Dr. Elaine Waetjen, gynecologist with the UC Davis Medical Center, has been studying urinary incontinence for more than 16 years and considers it an important but under-acknowledged issue in womens health. Her recent study, which analyzed nine years of data from 3,000 women ages 42-64, found that 68 percent of this group experiences the problem at least once a month.
Urinary incontinence has gained recognition in both the public and academic realms in recent years as female baby boomers reach middle and older age, Waetjen said. Because it usually affects women in their 40s, urinary incontinence has been associated with menopause. However, she said, there is no evidence that the relationship is causal.
More commonly, urinary incontinence results from the deterioration of certain muscles due to childbirth, or aging, or both, Waetjen said. Women over 40 commonly suffer from two types of urinary incontinence: stress incontinence and urge incontinence.
Stress incontinence is characterized by involuntary leakage during or after an event, such as coughing, sneezing or exercise. It usually occurs because of a weakness in pelvic floor muscles or the stretching out of the support tissues around the urethra.
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Kegel Exercises For Women
Strengthening pelvic floor muscles can reduce or even cure symptoms of stress incontinence. Kegel exercises target the muscles that control the flow of a stream of urine. You need to do the routine regularly to attain and maintain maximum benefit. Kegel exercises are easy to do it just takes a little practice to make sure you’re concentrating your efforts on the right area.
How to Do Kegel Exercises
To perform Kegel exercises, contract the muscles you use to stop a stream of urine. Hold for 3 seconds and then release. Relax for 3 seconds. Work up to 3 sets of 10 Kegels. You can start performing these workouts while lying down. As you get stronger, you can do them while sitting or standing. If you’re having trouble isolating the correct muscles, a doctor, nurse, or physical therapist can help you with your technique.
What To Expect At Your Healthcare Providers Appointment
During your appointment, your healthcare provider will likely ask questions about your symptoms. Theyll probably want to know how long youve been incontinent, which types of incontinence youve experienced, and other details.
They may also ask about your daily habits, including your typical diet and any medications or supplements that you take.
Depending on your symptoms and medical history, your healthcare provider may order additional tests, including:
- Collecting a sample of urine for analysis. Laboratory staff can check the urine sample for signs of infection or other problems.
- Measuring the amount of urine that you release when urinating, the amount left over in your bladder, and the pressure in your bladder. This information is gathered by inserting a catheter, or a small tube, into your urethra and your bladder.
- Conducting a cystoscopy. During this test, theyll insert a small camera into your bladder to examine it up close.
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Limit Caffeine And Alcohol
Caffeine and alcohol have a diuretic effect on your body. That means they increase the amount of urine you produce. If youre having trouble controlling your bladder, consuming caffeinated beverages may be contributing to the problem.
To help manage your symptoms, consider limiting caffeine and alcohol, or avoiding them altogether. Coffee, tea, soda, chocolate, and certain medications are common sources of caffeine.
Pelvic Floor Muscle Exercises
Also known as Kegel exercises, these exercises are especially effective for stress incontinence but may also help urge incontinence. To do pelvic floor muscle exercises, imagine that youre trying to stop your urine flow. Then:
- Tighten the muscles you would use to stop urinating and hold for five seconds, and then relax for five seconds.
- Work up to holding the contractions for 10 seconds at a time.
- Aim for at least three sets of 10 repetitions each day.
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Causes Of Stress Incontinence
Weak Tissues Lead to Leaks
Weakness of the pelvic floor muscles and tissues that support the bladder and urethra causes stress incontinence. These muscles and tissues may be weakened by a variety of things. Some of the factors that contribute to the disorder are modifiable, and some are not. Knowledge is power. Knowing the modifiable factors is the first step toward managing the condition.
Causes of Pelvic Floor Muscle Weakness
Anything that damages, stretches, or weakens pelvic floor muscles may lead to stress incontinence. Some causes cannot be changed. Increasing age and female gender increase the risk. Pelvic floor surgery, injury to the nerves in the lower back, chronic coughing, smoking, obesity, and pregnancy and childbirth are also causes. Women who have multiple pregnancies are at an even greater risk, as are those who have undergone a C-section.
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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Living With Bowel Or Bladder Incontinence
There is no single, right way to cope with bladder or bowel incontinence. The challenge is to find what is best for your situation, so you can get the help you need and return to a normal daily life. Talk with your health care team if you notice a change in bowel or bladder habits, and about the best ways to manage incontinence, if it is a problem. You might find it helpful to talk with other people who are dealing with incontinence, too. Ask a member of your cancer care team about support groups in your area.
Here are some things you can do that may help make incontinence less of a problem:
- Empty your bladder every 3 to 4 hours while awake, to avoid accidents.
- Empty your bladder before bedtime or before strenuous activity.
- Limit drinks with caffeine, or and avoid alcohol and citrus juices, which can irritate the bladder and make you have to go more often.
- Avoid hygiene products that may irritate you Women should avoid feminine spray or over-the-counter vaginal suppositories.
- Because belly fat can push on the bladder, avoiding weight gain or losing needed weight sometimes helps improve bladder control.
- Avoid tobacco use which can cause coughing and bladder irritation due to harmful substances in tobacco products.
- Talk to your doctor about all medicines, vitamins, herbs, and supplements youre taking. Some may affect urine control.
The Following Conditions May Also Add To Postpartum Bladder Control Problems
- Damage to the nerves that control the bladder, rectum and pelvic floor muscles.
- Movement of the urethra and bladder from their usual position.
- Having an episiotomy or experiencing a tear in the pelvic floor muscle during delivery.
- Undergoing an assisted vaginal delivery with either forceps or a vacuum, which can damage the pelvic floor and anal sphincter, leading to urinary or fecal incontinence.
Incontinence is common in new moms but can also develop in the months and years after childbirth some women dont experience problems until their 40s. Whenever postpartum incontinence issues begin to develop, women should consider making an appointment with a female pelvic health specialist. We offer many treatment options that can improve the mothers quality of life.
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Medication Triggers Of Urinary Incontinence
Check the Medicine Cabinet
Certain medications may trigger urinary incontinence or make it worse. Drugs that affect the brain, nervous system, muscle tone, and fluid balance may trigger the problem. Never stop taking a prescription or change the dose without speaking with your health professional. If you have concerns that a medicine you’re taking may be contributing to your symptoms, discuss the issue with your physician. It may be possible to substitute a problematic drug with another drug that does not cause side effects.
Some Medications Worsen The Problem
Certain classes of medicine increase the risk of incontinence symptoms. Blood pressure medications may relax the bladder, increase coughing, or decrease the tone of the urethral sphincter, all of which may contribute to this health concern. Pain relievers may increase fluid retention or relax or inhibit contraction of the bladder. Drugs to treat depression, Parkinson’s disease, or psychosis may increase the retention of urine. When you really need to urinate badly, some of that urine may leak. Antihistamines and anticholinergic drugs may have similar effects.
Incontinence And Emotional Health
Quality of Life Issue
Incontinence can take a serious toll on quality of life. Women who are affected by it report more depression and limitations in sexual and social functioning than those who do not have the condition. Those who suffer from this health concern are more likely to rely on caregivers. Incontinence also has a negative effect on self-esteem. In general, it negatively affects a woman’s quality of life, the more she should seek aggressive treatment.
An Honest Conversation
Many women feel embarrassed about suffering from incontinence, but they need not. This is a common problem and you are not alone. Effective treatments are available. Be honest with your doctor. Do you avoid certain activities because of your symptoms? Does incontinence impair your work, sleep, sex life, or social functioning? Different interventions are available depending on how it impacts you. Speaking candidly with your doctor is the best way to identify treatments that are most appropriate for your situation.
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Amping Up Your Treatment: Medications And Surgery
When more conservative measures have failed, medications – then surgery – are the alternatives, says Galloway.
Medications: No drug helps with stress incontinence, but a class called anticholinergics does help with urge incontinence.
A transdermal patch called Oxytrol has also been effective, says Galloway, who adds that skin irritation at the patch site does occur in some patients.
Surgery: There are 300 surgical options to treat incontinence, says Brubaker.
“The hard part is picking the surgery that has the best chance of working well for that woman long-term,” he says. “Surgery can create problems. It can cause difficulty in urinating, worsen an urge incontinence problem, or it can do nothing to solve the problem.”
A large NIH study is examining the use of a sling — a medical device that is surgically inserted into the vagina and positioned underneath the urethra, says Brubaker.
“It helps the urethral sphincter remain closed when abdominal pressure tries to open it. At least, we think that’s how it works,” he says. “We have only five-year outcomes on one group of these devices. But they look promising.”
Ways To Treat Bladder Leakage
With so many bladder leakage products and treatment options, how do you know what is the best one for you?
First, be sure to check in with your urologist or urogynecologist to see what may be causing your bladder leakage. Knowing the cause will help you and your doctor decide what treatment option will work best for you. While certain drinks, foods and medications may stimulate your bladder, there are other medical reasons that can cause your symptoms, including:
- Urinary tract infections
- Weakened pelvic floor, sometimes caused by pregnancy, childbirth, menopause or having had a hysterectomy
- Neurological disorders
Depending on what is causing your urinary incontinence, a unique treatment plan should be developed based on your personal situation, says Nina Bhatia, M.D., urogynecologist at Hackensack Meridian Health. There are several lifestyle changes, including bladder retraining techniques, dietary changes, avoiding bladder irritants, pelvic floor exercises and pelvic floor physical therapy that can help tremendously. If those fail to provide you relief, there are non-surgical and surgical options that we can offer.
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