Expert Answers to Your Questions About Regaining Bladder Control
Twenty-five million Americans experience unwanted leakage of urine, and 75 to 80 percent of them are women. Yet less than half of women who have bladder problems seek help. But, “Incontinence isn’t a normal part of aging, and it’s not something you have to live with,” says Diane Newman, DNP, co-director of the Penn Center for Continence and Pelvic Health in Philadelphia. Our panel of professionals tells you how to find solutions to this uncomfortable problem.
Are all leaky bladder problems the same?
Not exactly. In stress incontinence, the sphincter muscle that closes the urethra (the tube that lets you pass urine out of the body) is not strong enough, “much like a bad washer in a leaky faucet,” says Matthew Barber, M.D., a urogynecologist at the Cleveland Clinic in Ohio.
If you have stress incontinence, you might leak urine when exercising or sneezing, for instance. If you have urge incontinence, you might feel a sudden, powerful need to urinate and may feel you’ll have an accident if you don’t get to the bathroom in time. If you have overactive bladder, you may experience sudden, uncomfortable urges to urinate—due to bladder wall muscle spasms—and may or may not leak urine before reaching a toilet.
What’s causing my bladder problems?
The three biggest risk factors are age, obesity and having given birth to children vaginally, says Dr. Barber. Too much or too little fluid can also play a role. (You’re probably getting the right amount of fluid if your urine is pale to light yellow.)
Some medicine can cause frequent urination or constipation, and constipation may mistakenly send your brain a message that you need to empty your bladder, says Nancy Muller, Ph.D., director of the National Association for Continence in Charleston, SC.
What doctor should I see for urine leakage?
Start by talking to your primary care doctor or gynecologist. He or she may refer you to a continence care nurse for pelvic muscle retraining. In some cases, your doctor may suggest you see a urologist or a urogynecologist.
Is help for urinary incontinence really available?
Yes. Losing extra weight and practicing Kegel exercises help with both stress and urge incontinence, says Newman. If you have urge issues, your doctor may suggest prescription medication. While more than 50 percent of women see improvements with medication, many use medication for short-term relief in combination with Kegel exercises and weight loss.
Your doctor may also recommend a medical device such as a pessary—a small silicone product inserted into the vagina that helps prevent leakage from stress incontinence—or a minimally invasive outpatient procedure.
Kegel Exercise Tips
- Lie down on your back with your knees bent. As you get used to the movement, you can do Kegels while sitting or standing as well.
- Gradually pull in and hold a pelvic muscle-squeeze for three seconds, then relax for three seconds. The pelvic muscle hold should feel like you are trying not to pass gas. (Do not use your thigh or abdominal muscles.) Repeat this exercise 10 times, three times a day. After each set, add 10 quick squeezes.
- Increase the amount of time you hold the contraction by one second each week, until you can hold each contraction for 10 consecutive seconds.
From our sister publication, REMEDY’s Healthy Living (Spring 2012)