Help and FAQ's

What are the symptoms of incontinence?
Most people at some time in their life suffer a degree of incontinence which they can identify as purely circumstantial. However when there is repeated accidents when leakage or loss of urine occurs before a toilet can be reached, help must be sought.

How is incontinence diagnosed?
It is often possible for your doctor to diagnose the cause of incontinence from your symptoms alone. Your doctor may want to give you a physical examination to examine the vagina and pelvic structures.

Your doctor may also do a selection of tests, including a urine sample to check that you haven't got an infection, an x-ray or an ultrasound to check the pelvic organs, kidneys and the ureters. Other tests that you might have include a urodynamics study or a cystoscopy. A urodynamics study is used to measure and test urine flow and to check how your bladder fills and empties itself. A cystoscopy is a thin telescope which is inserted into the bladder to check that it is healthy.

These tests are important so that the doctor can distinguish between which type of incontinence you have, as the treatment is different for each type.

Difference types of incontinence

Stress Incontinence
Stress incontinence is the most common type of incontinence in women and occurs when the sphincter muscle gives way, when the bladder is put under pressure and some urine escapes. This can happen during activities such as, laughing, sneezing, coughing, running or when lifting things. In severe cases, urine might leak out when walking or getting up from the sitting position. In all cases only a small amount of urine is usually lost at any one time. Despite its name, stress incontinence is not caused by stress but by physical changes to the body. This usually occurs when the pelvic floor muscles become weak, this can happen because of child birth, weight gain, certain types of surgery or after the menopause.

Urge Incontinence
Urge incontinence this is another common type of incontinence and is caused by an overactive bladder. Urge incontinence occurs when you suddenly have the urgent need to pass urine and so you may pass a volume of urine before you are able to reach a toilet, you may also need to urinate frequently. An overactive bladder usually occurs because the bladder sends a message to the brain saying that is full when it usually isn't. The changes to these muscles can be caused by a bladder infection, drinking alcohol or certain medications. Urge incontinence is also common in people with nerve problems, such as multiple sclerosis, dementia and in those who have suffered a stroke. Urge incontinence can mean that your bladder empties itself during sleep, after drinking a small amount of water or even when you touch or hear running water. This type of incontinence is most common in older people and in women after the menopause.

Overflow Incontinence
Overflow incontinence this is when an obstruction develops and so the bladder cannot empty fully. As a result you may feel that your bladder is never completely empty or you feel you need to empty your bladder but can't. Overflow incontinence is common in older men, particularly if their prostate enlarges, as this can cause the urethra to become blocked. Urinary stones can also cause the urethra to be blocked. This type of incontinence is rare in women.

Functional Incontinence
Functional incontinence this type of incontinence occurs in people who have normal bladder control but are unable to reach a toilet in time due to a physical disability, such as Alzheimer's disease or a person in a wheelchair, who can be blocked from getting to the toilet in time.

If you suffer with a combination of two or more types of incontinence it is then called mixed incontinence.

Can Incontinence be Treated?
If you suffer with stress incontinence the main part of treatment is exercise to strengthen the muscles supporting the bladder and the pelvic organs. These exercises are known as kegel exercises, your doctor will help explain how to do these or refer you to a physiotherapist. Special weighted cones may also be used to help train the pelvic muscles. You might have to persist with the exercises for weeks before you begin to see an improvement.

If incontinence is not improved with exercise then surgery is an option. The operation will usually involve lifting and strengthening the bladder. Your doctor will discuss all options with you.

There are many medicines available to treat urge incontinence, these drugs are aimed at reducing the activity of the bladder. Your doctor may also recommend 'bladder training'. Bladder training is aimed at teaching the bladder not to send "I'm full" signals to the brain too early. Bladder training is carried out by learning to resist going to the toilet when you first have the urge to do so, the time you wait is then gradually increased. If the cause of your incontinence is a bladder infection you will be given drugs to treat it.

If your stress or urge incontinence symptoms have developed after the menopause, you may benefit from having oestrogen replacement therapy.

Overflow incontinence is treated by removing the cause of the obstruction.

People who suffer with functional incontinence should be helped by ensuring there is always a comode or urinal close to where they are and make sure their clothing is easy to remove. There are also a number of pads and devices which can be used to help maintain their dignity.

FAQ's

How common is bladder control loss?
Approximately 1 in 3 women over the age of 40 experience some degree of bladder control loss. This comes to an estimated 5million people in the UK.

Is bladder control loss a disease?
No, bladder control loss is not a disease but rather a symptom or side effect of another medical condition. That's why it's important to check with your doctor if you experience bladder control problems.

Why is bladder control loss more common among women than men?
A woman's urinary system is much different than a man's in many ways, and much more vulnerable to the type of problems (infections, muscle stretching and damage, complications in child birth, etc.) that can lead to bladder control loss.

What treatments are available for bladder control loss?
Medical science continues to discover more options for treatment and management every day. Surgeries are less invasive with fewer side effects and quicker recovery. More medications are available and absorbent products have improved a great deal. Your doctor will be able to recommend the right treatment for you.

Can my diet affect my bladder control?
Yes, watching what you eat and drink can help. Be sure to drink plenty of fluids-at least 6 ½ cups per day. Avoid beverages that can cause excessive urine production such as caffeine and alcohol. Also avoid acidic juices like grapefruit juice and tomato juice that can irritate the bladder. Constipation can also contribute to bladder control problems. Eat foods that are high in fibre to help you stay regular.

Does weight have an effect on bladder control?
Yes. Even a few pounds can make a difference. A five to ten percent weight loss can help improve bladder control by reducing intra-abdominal pressure.

I've been hearing a lot about "overactive bladder" What is this?
Overactive bladder is simply another name for urge incontinence, bladder irritations or unexpected muscle spasms that force urine out of the bladder.

Does weight have an effect on bladder control?
Yes. Even a few pounds can make a difference. A five to ten percent weight loss can help improve bladder control by reducing intra-abdominal pressure.

Can pelvic exercises help?
Your doctor may recommend that you practice bladder control exercises such as Kegel (or pelvic floor muscle training {PFMT}) exercises to help strengthen the muscles of the pelvic floor.

Should I continue with PFMT now my symptoms have improved?
Yes! Firstly a specific PFMT plan she be established for you, based on the condition of your pelvic floor muscles. The major drawback with this is that many women do not continue with these exercises as time goes by, but PFMT should be maintained for long term, in order to be effective.

If I have a bladder control problem, should I slow down and be less active?
No, bladder control problems can often be cured and can always be managed. Stay active and live life to the fullest. Help is available!

What about "bladder retraining", can this help?
Bladder retraining can be effective in helping people successfully increase the amount of time between trips to the bathroom. If your doctor suggests bladder retraining, a voiding diary, as well as a schedule of activities that normally make up your day, will be important in developing a successful program for you.

Should I stop smoking?
Although a direct link between smoking and UI has not been clearly proven, smoking is the primary cause of lung diseases. As a chronic cough will increase the severity of SUI symptoms, stopping smoking may help reduce the risk of SUI symptoms.

What about medications, can they help?
In some cases, your doctor may prescribe medication either alone, or in combination with behavioral treatment to help restore bladder control. Be aware that some medications may actually contribute to your bladder control problems. For this reason, be sure your doctor knows about all prescription and over-the counter drugs you're taking. All medications should be taken under the care of a physician.

Will I need surgery to treat my bladder control loss?
Although surgery is one of several available treatment options, it is usually reserved for suitable candidates who are unable to take advantage of the many non-surgical alternatives. Your health care professional can assist you in determining the best treatment for you.

Is bladder control loss a natural part of getting older?
No. Bladder control problems are not an inevitable part of getting older. According to the U.S. Agency for Health Care Policy and Research, 86 percent of people with bladder control loss who seek medical treatment realize improvements, including complete restoration of bladder control.

Does going through childbirth always result in bladder control loss?
Definitely not. The vast majority of women who have babies do not have bladder control loss and of those who do, most have a slight and temporary problem just before or just after childbirth.

Summary of Self Help Advice
There are number of things you can do to help yourself, they are as follows:

  • Avoid drinks that contain caffeine, such as cola and coffee as these can make you pass more urine.
  • Keep your weight down, if you are overweight incontinence is more likely to occur.
  • Empty the bladder at regular intervals so that it never becomes too full.
  • Exercise your pelvic floor muscles, this can be done by simply tightening the muscles of the pelvic floor as if you are trying to stop the flow of urine mid-flow.
  • Wear special pads to protect your skin from any leaking urine.
  • Take regular exercise, try to walk as much as possible.
  • Wear clothes that are easy to manage.
  • Avoid drinking alcohol, it is a diuretic and stimulates the kidneys to produce more urine.
     

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