Urinary Incontinence in Women

Solutions for a Leaky Bladder

Urinary Incontinence in Women | Johns Hopkins Medicine

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Research has found that at least half of people with urinary incontinence don’t discuss the condition with a health care provider. But there’s no need to feel embarrassed. If you have a leaky bladder, you’re definitely not alone. Bladder leakage, or urinary incontinence, affects women and men of all ages, though it becomes more common later in life.

And it’s definitely worth discussing, because of the many ways it can interfere with enjoying daily life—from exercise and travel to social outings and romance, says E. James Wright, M.D., director of urology at Johns Hopkins Bayview Medical Center.

What Causes Bladder Leaks?

There are two main types of urinary incontinence:

Stress incontinence 

If you have this type, activities that raise the pressure inside your abdomen cause urine to leak through the ring of muscle in your bladder that normally holds it in. Coughing, sneezing, jumping and lifting heavy objects could lead to a leak.

Going through childbirth, smoking or being overweight can raise the risk of stress incontinence for women, Wright says. Stress incontinence in men is rare, and when it arises, it’s often due to prostate cancer treatment, such as radiation or surgery.

Urge incontinence 

With this type, your brain, spinal cord and bladder don’t work together properly to allow you to hold and release urine at the right time. Your bladder may suddenly empty itself without warning. Or you may feel you need to urinate frequently, a problem called overactive bladder.

Some diseases that affect the nervous system, such as multiple sclerosis or stroke, can cause this kind of incontinence, says Wright. In men, an enlarged prostate may be the culprit. But in many cases, doctors don’t know what causes urge incontinence.

It is possible to have both types of incontinence at the same time.

Your doctor will want to know as much as possible about your bladder leaks—when they occur, how much urine comes out, and what you’re doing when leaks happen. Consider keeping a diary of when you urinate and when you have leaks, recommends Wright.

No matter what’s causing your bladder leakage, Wright offers good news: “The vast majority of cases can either be cured or significantly improved.” Some strategies that can help:

Watch your diet 

You may be able to cut down on bladder leaks by avoiding certain foods, drinks and ingredients, including:

  • Alcohol
  • Artificial sweeteners
  • Caffeine
  • Carbonated beverages
  • Chocolate
  • Citrus fruits and tomatoes
  • Corn syrup
  • Honey
  • Spicy foods

Shed extra pounds 

Research has found that overweight and obese women who lose weight report fewer episodes of bladder leakage.

Train your bladder 

Certain exercises can help you keep your bladder under better control:

  • Kegel exercises. During Kegels, you regularly tighten certain muscles in your pelvis to strengthen them, which helps you become more leak-proof.
  • The Knack. With this method, you do a Kegel just as you cough, sneeze or do another activity that tends to trigger a leak.

These require practice, Wright says. You may need a professional—your doctor or a physical therapist—to show you how to do them properly.

Know your options 

Depending on the type of incontinence you have, your doctor may recommend one of the following treatments, Wright says:

  • Medications that can help your bladder hold more, reduce urgency and improve your ability to empty your bladder. (There is even a recently approved over-the-counter patch for women with overactive bladder that helps relax the bladder muscle; the patch is available for men by prescription.)
  • An injection of Botox into the lining of your bladder to block the release of a chemical that prompts muscle contractions.
  • An injection of a thick substance around your urethra (the tube that carries urine your body) to help it hold back urine.
  • Surgery to insert a strip of mesh to press against your urethra and prevent leaks.

“Many solutions are available, but you can only get help for what you’re willing to talk about and explain,” Wright says. 

Source: https://www.hopkinsmedicine.org/health/conditions-and-diseases/urinary-incontinence/solutions-for-a-leaky-bladder

Causes of Urinary Incontinence, Treatments, and More

Urinary Incontinence in Women | Johns Hopkins Medicine

Urinary incontinence happens when you lose control of your bladder. In some cases, you may empty your bladder’s contents completely. In other cases, you may experience only minor leakage. The condition may be temporary or chronic, depending on its cause.

According to the Urology Care Foundation, millions of adults in the United States experience urinary incontinence. According to Johns Hopkins Medicine, it’s more common among women age 50 and over. However, this condition can affect anyone.

As you age, the muscles supporting your bladder tend to weaken, which can lead to urinary incontinence.

Many different health problems can also cause the condition. Symptoms can range from mild to severe and can be a sign of cancer, kidney stones, infection, or an enlarged prostate.

If you experience urinary incontinence, make an appointment with your healthcare provider. Urinary incontinence can interfere with your daily life and lead to potential accidents. Your healthcare provider can also determine if a more serious medical condition is the cause.

Urinary incontinence is divided into three general types. You can potentially experience more than one type at the same time.

Stress incontinence

Stress incontinence is triggered by certain types of physical activity.

For example, you might lose control of your bladder when you’re:

  • exercising
  • coughing
  • sneezing
  • laughing

Such activities put stress on the sphincter muscle that holds urine in your bladder. The added stress can cause the muscle to release urine.

Urge incontinence

Urge incontinence occurs when you lose control of your bladder after experiencing a sudden and strong urge to urinate. Once that urge hits, you may not be able to make it to the bathroom in.

Overflow incontinence

Overflow incontinence can occur if you don’t completely empty your bladder when you urinate. Later, some of the remaining urine may leak from your bladder. This type of incontinence is sometimes called “dribbling.”

There are many potential causes of urinary incontinence.

Examples include:

Some of these conditions are easily treatable and only cause temporary urinary problems. Others are more serious and persistent.

Aging

As you get older, the muscles supporting your bladder typically become weaker, which raises your risk for incontinence.

To maintain strong muscles and a healthy bladder, it’s important to practice healthy lifestyle habits. The healthier you are, the better your chances of avoiding incontinence as you age.

Damage

Your pelvic floor muscles support your bladder. Damage to these muscles can cause incontinence. It can be caused by certain types of surgery, such as a hysterectomy. It’s also a common result of pregnancy and childbirth.

Enlarged prostate

If you’re male, your prostate gland surrounds the neck of your bladder. This gland releases fluid that protects and nourishes your sperm. It tends to enlarge with age. It’s common for males to experience some incontinence as a result.

Cancer

Prostate or bladder cancer can cause incontinence. In some cases, treatments for cancer can also make it harder for you to control your bladder. Even benign tumors can cause incontinence by blocking your flow of urine.

Other potential causes

Other potential causes of incontinence include:

Some lifestyle factors can also cause temporary bouts of incontinence. For example, drinking too much alcohol, caffeinated beverages, or other fluids can cause you to temporarily lose control of your bladder.

Any instance of incontinence is reason to seek medical help. It may be a symptom of a more serious condition that needs to be treated.

Even if the underlying cause isn’t serious, incontinence can be a major disruption in your life. It’s important to get an accurate diagnosis and discuss treatment options with your healthcare provider.

In some cases, incontinence is a sign of a medical emergency.

You should seek immediate medical attention if you lose control of your bladder and experience any of the following symptoms:

During your appointment, your healthcare provider will ly ask questions about your symptoms. They’ll probably want to know how long you’ve been incontinent, which types of incontinence you’ve experienced, and other details.

They may also ask about your daily habits, including your typical diet and any medications or supplements that you take.

Depending on your symptoms and medical history, your healthcare provider may order additional tests, including:

  • Collecting a sample of urine for analysis. Laboratory staff can check the urine sample for signs of infection or other problems.
  • Measuring the amount of urine that you release when urinating, the amount left over in your bladder, and the pressure in your bladder. This information is gathered by inserting a catheter, or a small tube, into your urethra and your bladder.
  • Conducting a cystoscopy. During this test, they’ll insert a small camera into your bladder to examine it up close.

Your healthcare provider’s recommended treatment plan will depend on the cause of your incontinence. An underlying medical condition may require medication, surgery, or other treatments.

You may also be encouraged to do certain exercises, such as pelvic floor exercises or bladder training, which can help to increase your bladder control.

In certain situations, your healthcare provider may not be able to cure your bladder incontinence. In these cases, there are steps you can take to manage your condition.

For example, your healthcare provider may advise you to:

Source: https://www.healthline.com/health/urinary-incontinence

Excess pounds can lead to a leaky bladder

Urinary Incontinence in Women | Johns Hopkins Medicine

(Reuters Health) – Young and middle-aged women who are overweight or obese may be more ly to develop a leaky bladder, researchers say.

Australian researchers found that obese women were twice as ly as those at normal weight to leak urine, according to a paper in Obesity Reviews.

The effect was smaller among women who were overweight but not obese. These women were 35 percent more ly to be incontinent compared to normal-weight women.

While urine leakage may not severely impact health, “it can have significant impact on women’s well-being,” concluded the research team, led by Tayla Lamerton of the School of Movement and Nutrition Sciences at the University of Queensland. “Negative health outcomes associated with urinary incontinence include physical discomfort, odor and embarrassment.”

That fallout can, in turn, affect “physical activity, sleep and personal relationships,” the researchers wrote.

To determine the impact of obesity on urine leakage, Lamerton and her colleagues scoured the medical literature for studies with information on incontinence and weight.

They settled on 14 studies that contained data on 47,293 women from eight countries: Australia, France, the US, Denmark, England, Scotland, Wales and the Netherlands.

Studies were included only if the average age of the women was under 55.

Ultimately the researchers selected eight of the studies to include in a larger reanalysis. By combining the data from all eight, they were able to come up with stronger findings than any single study could provide.

After looking at incontinence overall, the researchers checked to see if there was any difference in the effects of weight on two different types: urge incontinence and stress incontinence. There wasn’t.

Urge incontinence, or overactive bladder, occurs when “the bladder squeezes and pushes urine out when you’re not asking it to,” explained Dr.

Stephanie Kielb, an associate professor of urology, medical education and gynecology at Northwestern University’s Feinberg School of Medicine in Chicago.

“Stress incontinence occurs when there is increased pressure on the abdomen and you leak urine after sneezing or coughing.”

Stress incontinence can develop when women are pregnant or when they are overweight because both “put so much more stress on the hammock of muscles and connective tissue at the bottom of the pelvis that holds the bladder and uterus in place,” Kielb, who was not affiliated with the new research, told Reuters Health by phone. “Overactive bladder is thought to be caused more by metabolic changes (that come with being overweight or obese). But nobody understands what causes it exactly.”

The new research showed that excess pounds can affect the risk of incontinence in all women, said Dr. Jeanne Clark, a professor of medicine and director of the division of general and internal medicine at Johns Hopkins Medicine in Baltimore, Maryland.

“People often think of this as something that affects older women,” said Clark, who is not affiliated with the new study. “But this shows it can affect younger women, too. And being overweight or obese is a risk factor.”

While it’s estimated that nearly 50 percent of women experience incontinence at some point, “fewer than half seek care,” Clark said by phone. “If it comes on all of a sudden, you should seek care because it could be due to a urinary tract infection. If it comes on gradually, you should still get it checked out because there are some things that can be done to help.”

Women who develop incontinence after putting on excess pounds will often see improvements if they lose weight, Clark said. And women who are overweight or obese and haven’t yet developed incontinence “should think about losing weight because that might prevent it from developing,” Clark said.

SOURCE: bit.ly/2OFZw0d Obesity Reviews, online September 19, 2018.

Our Standards:The Thomson Reuters Trust Principles.

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Source: https://www.reuters.com/article/us-health-obesity-incontinence/excess-pounds-can-lead-to-a-leaky-bladder-idUSKCN1M033Y

Bladder Disorders in Diabetes

Urinary Incontinence in Women | Johns Hopkins Medicine

— The first section of this topic is shown below —

  • Bladder dysfunction in diabetes mellitus (DM) spans a spectrum from lower urinary tract symptoms (LUTS) such as incontinence to bladder cystopathy.
  • Detrusor muscle, neurologic, and urothelial dysfunction underlie bladder dysfunction in DM.
  • Urge incontinence: involuntary loss of urine while feeling a need to urinate. Usually due to neurogenic detrusor overactivity (i.e., spastic bladder)
  • Stress incontinence: involuntary loss of urine that occurs during physical activity, such as coughing, sneezing, laughing, or exercise. Usually due to weak pelvic floor muscles.
  • Bladder cystopathy: decreased bladder sensation and contractility resulting in urinary retention, the most severe bladder disorder in DM. Usually due to autonomic neuropathy (also known as neurogenic bladder).

— To view the remaining sections of this topic, please sign in or purchase a subscription —

  • Bladder dysfunction in diabetes mellitus (DM) spans a spectrum from lower urinary tract symptoms (LUTS) such as incontinence to bladder cystopathy.
  • Detrusor muscle, neurologic, and urothelial dysfunction underlie bladder dysfunction in DM.
  • Urge incontinence: involuntary loss of urine while feeling a need to urinate. Usually due to neurogenic detrusor overactivity (i.e., spastic bladder)
  • Stress incontinence: involuntary loss of urine that occurs during physical activity, such as coughing, sneezing, laughing, or exercise. Usually due to weak pelvic floor muscles.
  • Bladder cystopathy: decreased bladder sensation and contractility resulting in urinary retention, the most severe bladder disorder in DM. Usually due to autonomic neuropathy (also known as neurogenic bladder).

There's more to see — the rest of this entry is available only to subscribers.

Tseng, Eva, and Nisa Maruthur. “Bladder Disorders in Diabetes.” Johns Hopkins Diabetes Guide, 2017. Johns Hopkins Guide, www.hopkinsguides.com/hopkins/view/Johns_Hopkins_Diabetes_Guide/547019/all/Bladder_Disorders_in_Diabetes. Tseng E, Maruthur N. Bladder Disorders in Diabetes. Johns Hopkins Diabetes Guide. 2017. https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_Diabetes_Guide/547019/all/Bladder_Disorders_in_Diabetes. Accessed May 18, 2020.Tseng, E., & Maruthur, N. (2017). Bladder Disorders in Diabetes. In Johns Hopkins Diabetes Guide Retrieved May 18, 2020, from https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_Diabetes_Guide/547019/all/Bladder_Disorders_in_DiabetesTseng E, Maruthur N. Bladder Disorders in Diabetes [Internet]. In: Johns Hopkins Diabetes Guide. ; 2017. [cited 2020 May 18]. Available from: https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_Diabetes_Guide/547019/all/Bladder_Disorders_in_Diabetes.* Article titles in AMA citation format should be in sentence-caseMLAAMAAPAVANCOUVERTY – ELECT1 – Bladder Disorders in DiabetesID – 547019A1 – Tseng,Eva,M.D.AU – Maruthur,Nisa,M.D., M.H.S.Y1 – 2017/09/04/BT – Johns Hopkins Diabetes GuideUR – https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_Diabetes_Guide/547019/all/Bladder_Disorders_in_DiabetesDB – Johns Hopkins GuideDP – Unbound MedicineER –

Source: https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_Diabetes_Guide/547019/all/Bladder_Disorders_in_Diabetes