Problems with Bladder Control? It's Common & Fixable

You cough a little and urine leaks out. Or your bladder is so touchy, you worry about whether you can get to the bathroom in time. But this is too embarrassing to tell anybody, so you ignore it as long as you can. Is this you?

You’re not alone

Incontinence, or leaking urine, is fairly common. More than 33 million Americans have some bladder control issues. And the sooner you talk to a health care professional, the sooner you can learn what’s at the root of your problem and what to do about it, advises Dr. Ali A. Dabaja, a urologist with Henry Ford Health System.

“Don’t be overly alarmed,” he says. “These symptoms are usually caused by conditions that can be easily treated.”

Maintaining a healthy weight and exercising can reduce the risk of incontinence and can improve symptoms, says Dr. Maria Victoria Estanol, a urogynecologist and pelvic reconstructive surgeon at Henry Ford. If those don’t do the trick, she says, “There are many options available to lessen the amount of incontinence and improve your quality of life.

Diagnosis may be simple

Often, the problem can be diagnosed through a simple history and a physical exam with minimal testing, which may include ruling out infections, says Dr. Dabaja. If not, your doctor can order testing to measure bladder pressure and urine flow. While men’s and women’s incontinence may have different causes, the treatment approach is often similar. Women may experience urinary incontinence as a result of pregnancy, vaginal delivery, aging, the hormonal changes of menopause, smoking, obesity or constipation. All of these can weaken the pelvic muscles, which can contribute to leakage. Most cases fall within three types:

Stress Urinary Incontinence

Symptoms: Leakage of urine that is noticed during coughing or sneezing, or by lifting something heavy.

Who: A third of women in all age groups have stress urinary incontinence, but it’s often “not bothersome,” Dr. Estanol says. Many women have a temporary case when pregnant. “If it persists after delivery but goes away, chances are, you are the one who will get it as you get older,” she says. Stress urinary incontinence is also common in men who have had surgery or treatment for prostate cancer.

Treatment: Initial care includes limiting fluid intake, planning regular urination, using protective pads and doing pelvic exercises. Reducing caffeine can also help. Medicines usually have little effect.

Surgery is the last option. Your health care provider will explain which procedures are best and when they might be needed.

Overactive Bladder

Who: About a third of all men and 4 in 10 women have some form of overactive bladder within their lifetimes, Estanol says. The exact cause of overactive bladder is not known, but nerve overactivity and sensitivity can lead to a constant urge to urinate and a loss of bladder control. Certain physical conditions, such as diabetes, Parkinson’s disease, multiple sclerosis, ALS and dementia increase risk of overactive bladder. In men, an enlarged bladder can be the cause. In women, menopause and aging can weaken the bladder muscles. Caffeinated drinks and spicy foods can worsen symptoms.

Symptoms: Urgency and frequency and loss of control during the urgency episode.

Treatment: Lifestyle changes, such as diet and exercise, as well as medications that reduce muscle spasms in the bladder and reduce the frequency and urgency of urination. Interventions, such as Botox injections in the bladder muscle, which calms the bladder and minimizes urgency, and nerve stimulation are available if other treatment fails. Talk to your doctor about what treatment is right for you.

Mixed incontinence

Who: Men and women who have both stress urinary incontinence and overactive bladder.

Treatment: Determined by which condition is most serious and bothersome.

Reduce the urge

You can exercise and train your bladder muscles to build strength and reduce urgency. While you can do these on your own, a physical therapist can help you get it right.

The most common pelvic exercises are kegels. Tighten the muscles you use to urinate and hold for three seconds, then relax for three seconds. Do three to five in a row.

Skin care & incontinence

Do

Do limit how much soap you use. Using soap after you urinate can irritate your skin. Instead, clean yourself well in your daily shower or bath using unscented, hypoallergenic soaps.

Don’t

Don’t use wipes; they can irritate the skin and keep it from adequately drying out. Plus, they can include chemical compounds that aggravate the chemicals in urine.

The good news

The good news is there are many options for treatment. The key is to never give up and continue working with your doctor.