Bladder control problems

Frequent bathroom breaks slowing you down?

Do you feel like you have to make too many urgent trips to the bathroom? Do you leak urine when you cough, sneeze, exercise or do other physical activities? Do you avoid going too far from home for fear that a bathroom may not be available? You’re not alone and there is help!

Individuals may be too embarrassed to talk to their providers about these concerns or think treatment is not possible, but millions of men and women around the world suffer in silence with bladder-control problems. In fact, around 40 percent of women and 30 percent of men are affected by an overactive bladder and can relate to what you’re going through. Over time, if left untreated, incontinence can cause men and women to become depressed and socially isolated, gain weight and develop low self-esteem, which can lead to other health issues.

So, what causes bladder-control problems?

The bladder, urethra, sacral nerves and pelvic floor muscles work together to support the urinary tract. As people age, muscles weaken and can lead to two common types of incontinence: stress incontinence and urge incontinence, also referred to as overactive bladder.

Stress incontinence occurs when added stress is suddenly placed on the bladder, such as when coughing, sneezing, jumping, lifting and the pelvic floor muscles are not strong enough to prevent urine from leaking. To help with stress incontinence, you can work with a physical therapist to strengthen your pelvic floor muscles by doing Kegels. Sometimes surgery offers a cure.

Urge incontinence or overactive bladder occurs when an individual feels a sudden urge to urinate that cannot be ignored followed often by an involuntary loss of urine. For some, triggers like running water, pulling the car into the driveway or stepping into the house can result in this urge. At other times, a person may feel the need to empty their bladders before it is truly full, resulting in frequent trips to the bathroom (more than eight times during the daytime hours and two times at night). On average, an individual should urinate every two to five hours during the day as the bladder can hold 16 to 20 ounces. The brain, bladder and pelvic floor muscles work together to help determine when we must go to the bathroom. If faulty communication occurs, this can lead to urge incontinence. The good news is this condition is treatable.

Many patients can manage or improve their symptoms through modifying their behaviors and working with a physical therapist, urologist and/or primary care provider. Some simple life changes and conservative approaches can improve urinary frequency or leakage, such as:

• Change your diet. Eliminate caffeine, spicy foods or drinking liquids late in the evening.
• Practice timed voiding. Empty your bladder based on the clock and not your urges can help establish more control over your bladder.
• Take medication. Medications known as anticholinergics can treat overactive bladder by relaxing the bladder.
• Work with a physical therapist who has special training to treat incontinence to help you find relief. Physical therapy can help you learn: urge suppression techniques; how to strengthen your pelvic floor muscles; how to lift, push or pull without causing leakage; and guide lifestyle changes that can have a positive impact on your bladder and bladder control issues.

Conservative approaches don’t always work to treat overactive bladder. In the case of overactive bladder, we now have many options that are more effective than medications for treating a strong need to urinate with leaking or wetting accidents (urge urinary incontinence), a strong need to urinate right away (urgency) and urinating often (frequency).

• InterStim Therapy is a minimally invasive nerve-stimulation procedure that has yielded long-term improvement or even a cure. Sacral neuromodulation, or InterStim Therapy, has been used to treat more than 150,000 patients worldwide and has been available in the United States since 1997.
• BOTOX® is a prescription medicine that is injected into the bladder muscle and used to treat overactive bladder symptoms, such as urgency, frequency and urge incontinence when another type of medicine (anticholinergic) does not work well enough or cannot be taken.
• Percutaneous Tibial Nerve Stimulation (PTNS) is a low-risk, non-surgical treatment. PTNS works by indirectly providing electrical stimulation to the nerves responsible for bladder and pelvic floor function. This electrical stimulation helps to relax the bladder muscle to treat urgency and frequency.

To make an appointment, call or schedule online with a Prevea gynecologist, urology therapist,  primary care provider or  urologist.