Sneezing, laughing, exercising, traveling — to some, these acts are nothing to think twice about. But for those suffering from a leaky bladder, they can be the very thing interfering with daily living. Urinary incontinence, also referred to as “leaky bladder,” is a leaking of urine caused by a loss of bladder control. The severity ranges from an occasional leak of urine when you cough or sneeze to having an urge to urinate that’s so sudden and strong you don’t get to a toilet in time. For many people, this condition causes feelings of embarrassment and discomfort, and that’s why many decline speaking about it with anyone — sometimes even their doctors. Not only a medical condition, leaky bladder can have emotional and psychological effects, as well, as people withdraw from activities they love due to the risk of having an accident. What’s the good news? With proper diagnosis and care from an experienced urologist, it is something that can be treated, managed and significantly improved.
So what’s behind this loss of bladder control? It’s most often caused by physical problems or changes to the body. There are two main types of urinary incontinence: stress incontinence and urge incontinence. (It’s possible to have both types at the same time.)
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Stress incontinence is one of the most common types of leakage and is caused by weakened pelvic muscles. The major symptom is leaking urine while you are active. During physical activity that puts extra pressure on the bladder — such as sneezing, coughing, laughing, heavy lifting or exercising — urine escapes through the weak muscles. Any time the body is under “stress,” a leak is bound to occur. This type of incontinence is most common in women who have gone through pregnancy and childbirth where the pelvic muscles have stretched and weakened and bladder nerves may have been damaged. Being overweight can also raise the risk of stress incontinence by putting extra pressure on the bladder and surrounding muscles that, over time, may weaken them.
Urge incontinence (also called overactive bladder, or OAB) occurs when your brain and bladder don’t work together properly to tell your body when to hold and release urine. The brain may send signals to the bladder telling it to empty without warning, or the muscles can be too active and contract frequently before the bladder is full, causing feelings of extreme urgency and frequency. The major symptom is a sudden, strong urge to urinate that you cannot control. Urge incontinence is most common in men with prostate problems such as prostate cancer and BPH, and it can also be a temporary side effect of prostate cancer treatment. This type of leakage is also common in women who are going through menopause, due to the lack of estrogen being produced. In addition, some diseases that affect the nervous system, such as multiple sclerosis or stroke, can interfere with nerve signals involved in bladder control.
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Your risk for either type of incontinence can be raised if you have a family history of someone with bladder leakage or you’re a tobacco smoker, or simply from getting older — the bladder muscles lose some of their strength as we age and are no longer able to hold as much urine.
If you feel like you might be experiencing some of these symptoms, describing them to your urologist can help him or her diagnose which type of incontinence you’re experiencing. Then, your doctor can evelop a treatment plan that’s right for you. To find out why the bladder is leaking, a urologist may sometimes order a urinalysis or a post-void residual measurement to detect any infection or blockage that might be to blame for the symptoms.
The treatment then depends on the type of incontinence and the underlying cause. The least invasive methods are preferred first and include: bladder training to delay urination after getting an urge to go, learning how to empty your bladder more completely each time you go, scheduling toilet trips at specific times every day and avoiding foods that may aggravate the bladder, such as alcohol, caffeine and acidic foods. Losing weight can also help relieve some pressure off the bladder, leading to fewer episodes of bladder leakage. If the behavioral techniques fail to better control urination, medications can be prescribed to help the bladder hold more urine and to reduce feelings of urgency and frequency by relaxing the bladder muscles. In more severe cases (and again depending on the underlying cause), surgery may be recommended to repair the problem from the inside.
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If a leaky bladder is affecting your daily life, know that you’re not alone, and please don’t hesitate to schedule an appointment with your urologist. The right diagnosis and treatment plan can quickly give you your confidence back and get you back out there doing the things you love, without the leakage worries.
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Leaky Bladder: Understanding the Two Main Types of Urinary Incontinence originally appeared on usnews.com
