Bladder Leakage 3 Things Women Should Know About Urinary Incontinence
To dispel misconceptions, a urogynecologist discusses the surprisingly common, lingering issue many women experience.
Bladder leakage. For some women, the condition runs their life from the inside, preventing them from playing outside with their kids, going to a workout class or staying the night with family or friends.
And theyre not alone. Living with some degree of urinary incontinence, defined as an uncontrolled leakage of urine, is actually common, according to Pamela Fairchild, M.D., a urogynecologist at Von Voigtlander Womans Hospital at Michigan Medicine.
She says that approximately half of all women over the age of 20 experience some degree of incontinence. This means urinary incontinence isnt just an issue that affects elderly or postpartum women, although aging and childbirth are risk factors.
But if so many women experience it, then why does the topic still seem embarrassing?
Women get the sense that this is inevitable, that its a natural part of aging and they have to live with it, says Fairchild. This false perception leaves women feeling powerless, even though there are ways to greatly improve their quality of life.
To help overcome the stigma, Fairchild shared three facts about urinary incontinence that all women should know.
What Causes Bladder Leakage In Women
The three types of urinary incontinence and main causes of bladder leaking are:
- Stress incontinence
- Urge incontinence
- Overflow incontinence
Stress incontinence is the most common cause of bladder leakage in women and is the result of a weakened pelvic floor. The pelvic floor is the system of muscles and ligaments that form a basket of support for your bladder and uterus. The pelvic floor helps regulate the urinary sphincter, which controls the flow of urine out of the bladder. The pelvic floor can be weakened by life events such as pregnancy, childbirth or being overweight. Once weakened, any pressure â or stress â placed on the pelvic floor causes a small amount of urine to leave the bladder. This can be from coughing, laughing, sneezing, exercising or lifting objects.
Urge incontinence , also known as overactive bladder or OAB, is the result of nerve damage to the nerves in and around the bladder, either as a result of a neurological disease like multiple sclerosis or Parkinsonâs or due to previous pelvic surgery or injury. This nerve damage means that the nerves and muscles in your bladder spasm and fire off too often, sending you on a mad dash to the bathroom. This means that your bladder signals that itâs time to go even when itâs not full. The urge to urinate then comes on suddenly and intensely, to the point that you often may not make it to the toilet in time to urinate.
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.
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Bladder Leakage Solutions Treatments & Remedies
Just because you experience bladder control issues does not mean you must resign yourself to embarrassing accidents. Here are tips to prevent and protect yourself from bladder leaks:
1. Stay on a scheduleMake a drink scheduleThough it may be tempting to drastically limit fluid intake for fear of leaking urine, this is not advised. Donât limit fluids to the point of dehydration. Instead, drink prescribed amounts throughout the day in order to avoid overstressing your bladder with a large amount of fluid all at once.
Make a âgoâ scheduleKeeping your bladder empty will go a long way in reducing little bladder leaks throughout the day. Use the bathroom on a fixed schedule, say every two hours. Be sure to go whether or not you feel the need to. That way you can reduce your chances of a bladder leak if you find yourself laughing, coughing, or lifting with a full bladder.
2. Get movingLosing weight can help ease bladder leakage by removing one of its root causes â being overweight. Even a daily walk around the block to get moving can go a long way in shedding some extra pounds. Learn more about how obesity and diabetes can cause incontinence and bladder leakage.
If you want to find out more, read our complete guide on pelvic floor exercises.
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What Else Causes Bladder Control Problems In Women
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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Causes Of Overflow Incontinence
Unlike other types of incontinence, overflow incontinence is more common in men than women. The most common cause in men is an enlarged prostate, which impedes the flow of urine out of the bladder. Other possible causes of overflow incontinence include:
- Blockages of the urethra from tumors, urinary stones, scar tissue, swelling from infection, or kinks caused by dropping of the bladder within the abdomen
- Weak bladder muscles, which are unable to squeeze the bladder empty
- Injury of nerves that affect the bladder
- Nerve damage from diseases such as diabetes, alcoholism, Parkinson’s disease, multiple sclerosis, back problems/back surgery, or spina bifida
- Medications, including some anticonvulsants and antidepressants, that affect nerve signals to the bladder
Why You May Have Bladder Leaks At Night
Often times, bladder leakage at night is a form of overflow incontinence. If you experience overflow incontinence, the involuntary release of urine from an overly full bladder, you likely experience urine leaks â a lot! Even at night. You naturally have to use the bathroom less while youâre sleeping than when youâre awake. This is because your body produces a hormone called ADH â anti diuretic hormone â that signals to your kidneys to produce less urine. However, some people donât produce the appropriate amount of ADH at night, leading to too much urine production.
Alternatively, even if your body produces enough ADH, your kidneys may not respond to the hormone. This means that your body will still produce too much urine, leading to maximum bladder capacity and leakage at night.
Often times, bedwetting in adults is genetic. If one of your parents wets the bed, you have a 40 percent chance of wetting the bed at some point in your adult life as well.
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Products And Medical Devices
You may be able to use the following products to help stop or catch leaks:
Adult undergarments are similar in bulk to normal underwear but absorb leaks. You can wear them under everyday clothing. Men may need to use a drip collector, which is absorbent padding held in place by close-fitting underwear.
A catheter is a soft tube you insert into your urethra several times a day to drain your bladder.
Inserts for women can help with different incontinence-related issues:
- A pessary is a stiff vaginal ring you insert and wear all day. If you have a prolapsed uterus or bladder, the ring helps hold your bladder in place to prevent urine leakage.
- A urethral insert is a disposable device similar to a tampon that you insert into the urethra to stop leaks. You put it in before doing any physical activity that usually causes incontinence and remove it before urinating.
How Is Urinary Incontinence Diagnosed
Urinary incontinence is easy to recognize. The primary symptom most people experience is an involuntary release of urine. But the type and cause of the incontinence can be more difficult to determine and may require a variety of exams and tests. Most physicians will use the following:
A bladder diary Your doctor may have you track your fluid intake and output over several days. This may include any episodes of incontinence or urgency issues. To help you measure the amount of urine you pass during an episode of incontinence, you may be asked to use a calibrated container that fits over your toilet to collect the urine.
Urinalysis A urine sample can be checked for infections, traces of blood, or other abnormalities, such as the presence of cancer cells. A urine culture can assess for infection urine cytology looks for cancer cells.
Blood tests Blood tests can look for chemicals and substances that may relate to conditions causing the incontinence.
Pelvic ultrasound In this imaging test, an ultrasound device is used to create an image of the bladder or other parts of the urinary tract to check for problems.
Postvoid residual measurement In this procedure, the patient empties the bladder completely and the physician uses a device to measure how much urine, if any, remains in the bladder. A large amount of residual urine in the bladder suggests overflow incontinence.
UI is usually curable, and if not, then controllable.
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Take Care Of Your Skin
If you’ve got OAB, you may also have a higher risk of rashes and skin breakdowns.
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.
Nocturia Treatment: How Can I Stop Excessive Urination At Night
Bladder leaks at night, or nocturia, can leave you with some wet clothes and sheets to grapple with in the morning.
If you have a sensitive bladder that spasms involuntarily, you may not wake up in time to use the facilities. Nighttime incontinence of this sort is best treated through lifestyle adjustments.
Use these tips and remedies to treat nocturia and frequent urination at night.
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Surgery And Procedures For Urinary Incontinence
If other treatments for urinary incontinence are unsuccessful or unsuitable, surgery or other procedures may be recommended.
Before making a decision, discuss the risks and benefits with a specialist, as well as any possible alternative treatments.
If you are a woman and plan to have children, this will affect your decision, because the physical strain of pregnancy and childbirth can sometimes cause surgical treatments to fail. Therefore, you may wish to wait until you no longer want to have any more children before having surgery.
The various surgical treatments for urinary incontinence are outlined below.
Diet And Exercise Can Help Stop Bladder Leakage
After an initial evaluation with your healthcare provider, youll receive a treatment plan to follow at home. Recommended therapies may include dietary changes, pelvic floor exercises and/or medication.
For those with urge incontinence, tweaking your diet can help reduce urge incontinence. For example, you might need to scale back on caffeine since the stimulant can sensitize your bladder and increase your urge to urinate. Other foods like milk, tomatoes, avocados and certain fruits can stimulate your urinary tract in a similar way, too.
Often, you can also reduce incontinence with pelvic floor physical therapy. Your first session includes an internal and external assessment of the alignment, flexibility and muscle tone in your pelvic area. Based on that exam, your therapist creates an exercise program and goals for you to work on.
Pelvic exercises increase your range of motion and muscle strength. Your therapist may also use biofeedback, an electronic monitoring tool that shows how much pressure or contraction you can generate with your pelvic floor.
The best part about getting medical treatment for bladder leakage? You can see significant improvement in three to four months, Eutsler said.
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Leaking Urine During Pregnancy: Causes And Coping Methods
Leaking urine is a common hazard for many pregnant women. However, the problem is worse for some than others. Urinary incontinence or involuntary passage of some urine happens occasionally in many women, and more frequently in others. A woman’s body mass index and age are some of the known risk factors of incontinence during pregnancy.
Diagnosis Of Urinary Incontinence
The first step in treating incontinence is to see a doctor. He or she will give you a physical exam and take your medical history. The doctor will ask about your symptoms and the medicines you use. He or she will want to know if you have been sick recently or had surgery. Your doctor also may do a number of tests. These might include:
- Urine and blood tests
- Tests that measure how well you empty your bladder
In addition, your doctor may ask you to keep a daily diary of when you urinate and when you leak urine. Your family doctor may also send you to a urologist, a doctor who specializes in urinary tract problems.
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Treatment Of Leaking Urine In Dogs
Depending on the cause of the urinary leakage, treatment will vary. Antibiotics or other medications are commonly used for urinary tract infections, hormone depletion, and other diseases, surgery and dietary changes may be needed for bladder stones, and acupuncture, discontinuation of medications if they are causing side effects, or other treatments for underlying diseases may be necessary to treat the various causes of urinary leakage.
How Common Is Urinary Incontinence
Its common for a new mother to accidentally leak urine when she laughs, sneezes, coughs or exercises. This is known as stress incontinence.
You are more likely to develop stress incontinence after birth if you:
- have bladder or bowel problems before pregnancy they are likely to get worse after the birth
- have a long labour, especially a long second stage of labour
- have a difficult delivery, such as needing stitches, tearing, or needing a vacuum cup or forceps during the delivery
Women who have a caesarean can also develop bladder problems. Having a caesarean can reduce the risk of severe incontinence from 10% to 5% for the first baby, but after the third caesarean women are just as likely to develop bladder problems as women who give birth vaginally.
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How Do You Treat Leaks After A Hysterectomy
There are some treatments available for this issue. Urinary incontinence can be treated with pelvic physical therapy, pessaries, or medication.
If you have pain during sex or urination after surgery, talk with your surgeon. Your doctor may recommend behavioral changes, pelvic floor exercises, or medications that improve bladder control
Surgery to repair the damage to pelvic muscles and nerves may also be an option for some women. In severe cases, an artificial urinary sphincter or a sling may be recommended. In addition, surgery to lift the urethra and bladder neck can improve stress incontinence
In most cases, surgeries to treat incontinence are successful. But in some cases, treatment might not resolve this issue.
These treatments come with risks, so make sure to talk with a doctor before beginning any new treatment
If youve experienced leaking urine after your hysterectomy, please leave a comment below. Wed love to hear from you!
Urinary Leakage And Pregnancy
Many women experience urinary incontinence during pregnancy because the weight of a growing fetus puts additional pressure on the bladder.
Right after delivery is usually the worst that it will be, and it should improve up to six weeks after delivery, Dr. Crisp says. What doesnt get better after that isnt going to improve without some additional help physical therapy, medication or surgery.
Leakage caused by pregnancy is a type of pelvic floor disorder, which occurs when the muscles that control urination become weak or damaged. Pelvic floor disorders usually affect about 1 in 3 women, she points out.
Women who have a cesarean section are less likely to have prolapse until they reach menopause. Once a patient is menopausal, there is no difference in the rates of prolapse whether the patient had a C-section or a vaginal delivery. However, she reminds patients to not make a decision for a vaginal delivery versus a C-section based on this probability. Whats more important to you should be: Whats the best thing for my baby?
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