February 26, 2020

Millions of Americans suffer from urinary incontinence. Although this embarrassing condition is common, you don’t need to resign yourself to living with the constant struggle. 

What is urinary incontinence?

Urinary incontinence is the uncontrolled leakage of urine that has become disruptive and problematic in everyday life. The severity can range from occasional leakage to a sudden urge so strong that a restroom may not be reached in time. But bladder leakage isn’t just a medical problem. It can wreak havoc on one’s emotional, psychological and social life as well. 

For many, a few instances of bladder leakage are no more than an inconvenience and do not require medical attention.Treatment is needed, however, if the fear of bladder control is driving your decision-making or causing you to:

  • Fear being too far from a restroom.
  • ​​Avoid important activities.
  • Withdraw from social interaction.
  • Increase risk of injury during the rush to get to the bathroom.
  • Limit physical activity.
  • Stop enjoying everyday life. 

Most symptoms can be treated, stopping bladder problems from controlling your life. 

Temporary urinary incontinence 

Bladder control issues can be temporary and short-lived. This kind of incontinence is easily remedied and symptoms often disappear with the right kind of treatment. Causes of temporary urinary incontinence include: 

  • Diuretics: Certain food and drink can act to stimulate your bladder and increase urine volume. These include: alcohol, caffeinated drinks, artificial sweeteners, and chocolate. Identifying and eliminating the intake of such foods can increase bladder control and eliminate leakage. 

  • Medication: Some medications, such as heart and blood pressure medicines, sedatives and large doses of vitamin C can act as diuretics to your system. It is best to check with your doctor about potential side effects and medication changes to alleviate bladder control symptoms. 

  • Infections: Vaginal and urinary infections can irritate the bladder causing increased urges and incontinence. Most bladder issues are resolved with the successful treatment of the infection. 

  • Constipation: Located near the bladder, the rectum shares many of the same nerves as the bladder. These nerves may overreact and increase urine frequency during constipation. 

Persistent urinary incontinence

If the cause isn’t temporary, the leakage is most likely the result of underlying physical changes or problems caused by more persistent bladder control issues. These can include:

  • Pregnancy: Hormonal changes and the weight of the fetus on pelvic muscles can lead to stress incontinence. The number of children carried can increase the risk. 

  • Childbirth: During vaginal delivery, muscles used for bladder control can be weakened. Also, damaged bladder nerves and supportive tissue can lead to a dropped (prolapsed) pelvic floor. This prolapse pushes the bladder, uterus, rectum or small intestine from its usual positioning and is associated with incontinence. 

  • Age: With most parts of the body, aging can decrease the effectiveness of the bladder. The muscles can weaken and involuntary bladder contractions occur more frequently, leading to bladder leakage or loss of control. 

  • Menopause: Menopause decreases the production of estrogen in women. This hormone helps to keep the lining of the bladder and urethra healthy. Without enough estrogen, these tissues can deteriorate, causing incontinence. 

  • Reproductive surgery: Any surgery involving a woman’s reproductive system, such as a c-section or hysterectomy, can damage the pelvic floor muscles and nerves leading to incontinence.

  • Neurological disorders: Conditions such as multiple sclerosis, Parkinson’s disease, stroke or a spinal injury can affect the nerve signals, creating urinary incontinence. 

  • Weight: Maintaining a healthy weight is important for all the functions of the body, including the bladder. Extra weight can increase pressure on the bladder and surrounding muscles, weakening them and allowing the leakage of urine. 

  • Smoking: Tobacco use has been linked to poor overall health, including urinary incontinence. 

Different kinds of persistent urinary incontinence

There are several diagnoses for persistent urinary incontinence. Each is identified by the exhibited symptoms and evaluation of a medical professional. Some of the most common form of incontinence conditions are:

  • Stress incontinence (SUI): The most common urinary incontinence, SUIs are the result of added pressure—or stress—on the bladder’s system. The pelvis, muscles of the bladder or both aren’t strong enough to hold the urine or are unable to keep the bladder neck closed. 

    The most common symptom is leaking while active. Forces of gravity pull on the tissue and other pressures, like coughing and sneezing, can add more strain. Kids, weight, and genetic tissue degradation all contribute to the development of SUIs. 

  • Urgency incontinence: This condition often involves a sudden, strong need to urinate that is uncontrollable. This type of incontinence can also include a normal sensation, but a rapid, unstoppable elimination as the bladder muscles contract too much. 

    As the bladder fills and gradually stretches, there is a feeling of needing to eliminate urine when the bladder is roughly half full. Most of the time, the bladder can be controlled until there is a convenient time to visit the bathroom. However, for those experiencing urgency incontinence, the bladder will let loose involuntarily, even emptying the whole bladder. 

    Though the reasoning for this condition is specific to the individual, some things may trigger the response. Events such as unlocking the door (key-in-lock syndrome,) approaching a toilet or hearing running water can overcome the pelvic floor muscles’ ability to retain urine. 

  • Mixed incontinence: Mixed incontinence occurs with more than one type of incontinence. Symptoms include leaking as well as a sudden strong urge to urinate. 

  • Neurogenic incontinence: A physical or mental impairment that interferes with the ability to control the bladder due to brain, spinal cord or nervous system problems.  

Your role in treating incontinence

Doctors will most often suggest lifestyle modifications as a first step in treating bladder control issues. Safe, easy, effective and inexpensive, these techniques can be tried before other types of treatments. 

  • Monitor food and fluids. Bladder control can be influenced by too much liquid intake, too little intake and food choices. Too much liquid can increase the need to urinate while too little can cause irritation in the bladder from the buildup of body waste. Certain foods that are spicy or acidic, tomato based foods, and even chocolate can irritate the bladder disrupting its normal function. 

    Monitor food and fluid intake for about a week, eliminating bladder irritants to evaluate symptoms for improvement. Food and drink can then slowly be reintroduced—one about every two days. Some food and drink may need to be eliminated completely, while cutting down on others may be enough. 

  • Bladder training. By adjusting bathroom habits, control over bladder function can be achieved. 

    Identify a pattern by keeping a diary of urination times in order to make a schedule for bladder training. Designate times to use the bathroom based on your current habits. Then gradually extend the intervals between urination by 15 minutes. Continue to slowly lengthen the time between trips to the toilet until you reach intervals of 2-4 hours.

  • Kegel exercises. The pelvic floor holds up the organs of the pelvis, including the urethra, uterus, vagina, bladder and rectum. Kegel exercises can make those muscles stronger to support proper bladder function.

    Dr. Heegaard’s infographic is a handy tool to guide kegel exercises for stronger pelvic muscles. 

Doctor intervention

Behavior therapy takes time and practice to effectively improve bladder control. However, if these approaches don’t work, it may be time to talk to the doctor regarding other medical options for treating incontinence. 

The most common medical treatments include: 

  • Estrogen treatment. Estrogen treatments can increase the tissue in post-menopausal women when incontinence is related to the lowered estrogen levels of menopause.

  • Pessaries. An effective treatment that has been around since the Egyptians, pessaries are developed in multiple shapes with varying functions. These latex devices offer support by working to correct the structural problem. The top wall of the vagina is prevented from pushing into the vaginal space and putting additional pressure on the bladder. 

  • Collecting systems. Catheters and drainage bags help manage urinary retention and incontinence. These systems collect urine internally or externally and offer some patients freedoms when dealing with incontinence. 

Surgical intervention

The sling is the newest and safest trend to restore the bladder system’s function. With a 95% success rate, this 15- to 30-minute surgery is performed on an out-patient basis and returns patients to normal activity quickly and confidently. 

During the procedure, polypropylene, an inert nylon-type material, is placed under the mid urethra to act as a backboard to decrease or stop the leakage of urine. Recovery may include some bruising and groin tenderness as small incisions are made in the crease of the inner thigh.  Patients return home and back to their regular schedules the same day. 

Don’t suffer, talk with Dr. Heegaard

For over two decades, Dr. Eric Heegaard has been at the forefront of minimally invasive gynecology surgical practices. Dedicated to women’s physical and emotional health and well-being, Dr. Heegaard combines his outstanding surgical abilities with his caring, gentle personality. 

Don’t let the embarrassment of urinary incontinence control your life. If you are one of the many experiencing bladder control problems, there are options to help you live a better life. You don’t have to suffer.  Ease the discomfort or stop bladder control issues now. Contact Dr. Heegard to find the treatment that’s right for you.