Urinary incontinence, leaky bladder, bladder control issues – all are terms for a very annoying, uncomfortable and, sometimes, embarrassing condition that affects millions of women in America. Contrary to urban myth and wives tales, urinary incontinence is not an inevitable result of aging or having children.
In fact, in almost all cases, it can be helped or completely cured. Research tells us that as many as half of those who suffer some form of urinary incontinence don’t discuss it with their healthcare provider, and live with the symptoms and side effects unnecessarily. Please, if you experience a leaky bladder, schedule an appointment with your doctor or gynecologist and let her/him know.
Help is on the horizon!
Odds are you’re experiencing stress incontinence
While urinary incontinence isn’t inevitable, it is certainly more common in women, most common in older women (55-years and older) and risk factors increase because of pregnancy, vaginal childbirth and menopause.
If you are pregnant or have recently had a baby, temporary incontinence is probably a given. The great news about this is that the uterine contractions that tone your pelvic region and abdomen back up will also help to work those pelvic floor muscles (keep in mind that breast-feeding facilitates pelvic toning). This, however, may not be enough to strengthen your Kegels and pelvic floor muscles back to their pre-pregnancy condition. We recommend reading, Healing After Childbirth – A Gentle Guide (and Timeline) for more information about what to expect and the things you can do to help your body heal and recoup.
The type of incontinence you have (yes, there are different types) will help you and your care provider determine which treatment method(s) is best. We always advocate the most natural and least invasive methods first, and these are effective for all but some of the most severe cases.
- Stress incontinence. That little (or big!) leak you feel when you jump on the trampoline with the kids, sneeze, cough, or run down the stairs – that’s stress incontinence. It happens as the result of pressure placed on weakened bladder and kegel muscles. It’s the most common type of incontinence in younger and middle-aged women, and the most typical type triggered by menopause. Stress incontinence is also the most responsive to pelvic floor exercise and lifestyle changes.
- Urge incontinence. This form of incontinence occurs when you have a full bladder, and can’t get to a toilet in time to keep it from leaking. If you suffer from stress incontinence and weakened pelvic/bladder muscles, you can wind up experiencing occasional urge incontinence – especially if you drink alcohol, caffeine or consume fluids in quantities larger than normal. Otherwise, chronic urge incontinence is most common in adults with diabetes, Parkinson’s, Alzheimer’s, multiple sclerosis or those who have had a stroke.
- Overflow and functional incontinence. These are most likely not your issue. Overflow incontinence is most often experienced by men with enlarged prostates, and functional incontinence occurs in adults who have difficulty getting to a bathroom in time as the result of a medical condition or mobility issue.
Stress incontinence is highly treatable with exercise and lifestyle changes
Some of the most common treatments for stress incontinence include:
Diet and lifestyle changes
There are certain things that exacerbate stress incontinence. These include:
- Obesity – losing weight will help so make sure exercise, in addition to pelvic strengthening becomes part of your routine.
- Carbonated beverages
- Holding urine for extended periods of time when you feel the urge to go
- Citrus fruits and tomatoes
- Corn syrup
- Artificial sweeteners
Working to control these triggers or contributors will increase the effectiveness of any of the treatments listed below.
Exercise for the pelvic muscles or pelvic physical therapy
The first thing your doctor should do after determining you have stress incontinence is to figure out the reasons why. If weakened muscles are the only cause, or if mild pelvic organ prolapse is a concern (pelvic organs can begin to shift lower into the pelvic cavity when muscles and connective tissue grow weak), pelvic floor exercises, such as Kegels and certain yoga or Pilates-type exercises, might be all you need to get things under control (literally).
If you have a more moderate or severe case of pelvic organ prolapse, we recommend looking for a physical therapist who focuses on pelvic floor strengthening. Physical therapy can work wonders.
This method uses sensors that help to enhance your body’s signals so you can be more responsive when you feel the urge to urinate. Biofeedback is a temporary solution and is often used in conjunction with exercise, timed voiding, etc.
Timed voiding or timed urination
Getting your body on a set schedule, in combination with exercises, can help support bladder control. With this method, you begin urinating on a schedule. At first, it might be every hour. Over time, as you regain control, you can extend the time between bathroom visits.
There are certain devices like urinary inserts (sort of like a tampon for the urethra that can be inserted before activities that cause problems – like aerobics or tennis). These act as a plug that keep leakage from being evident, and that are removed before you use the bathroom.
These are commonly used to provide stability for the pelvic floor for women with more moderate to severe pelvic organ prolapse who are not interested in surgical intervention. They are inserted into the vagina, like a stiff ring, and help to hold up the upper-vagina, the bladder, and other organs that may put pressure on the bladder and contribute to incontinence.
If physical and lifestyle/diet recommendations don’t help, you don’t find relief, and/or you are diagnosed with urge incontinence. Your doctor may speak with out about medication options. In most cases, these medications are not prescribed for women with stress incontinence.
Finally, surgical interventions may be an option but these should always be a last resort. Are you concerned about incontinence or leakage that doesn’t seem to respond to normal Kegels or general lifestyle changes? Schedule an appointment with us here at Overlake and we’ll work with you to create an effective treatment plan that keeps you confident and active.