More than 13 million Americans have trouble controlling their bladder. Urinary incontinence is not a disease; it’s a symptom of an underlying problem like diabetes, stroke, multiple sclerosis, Parkinson’s disease, or chronic bladder infection.
Obesity, smoking, and women who have recently had a baby face a heightening risk for incontinence. Passing the baby through the birth canal often damages the abdominal muscles responsible for holding and releasing urine.
In men, incontinence is usually a result of nerve damage caused by surgery to treat prostate enlargement or cancer.
Good news: incontinence can often be prevented or controlled.
If you have urinary incontinence or are worried that you might become incontinent, avoid caffeine, alcohol, spicy foods, chocolate, artificial sweeteners, and other bladder irritants. Also, make it a habit to urinate before and after sexual intercourse to expel infection-causing bacteria and drink lots of water.
Do not drink large quantities of water at one time because it can cause the bladder to fill too rapidly, making it more challenging to control urine leakage; instead, have one sip with five to ten minutes interval throughout the day.
Women: to keep pelvic floor muscles strong do Kegel exercises.
Women with recurrent bladder infections should take a cranberry pill with each meal. The tablets contain compounds that keep infection-causing bacteria sticking to the bladder wall. Cranberry and cranberry juice also have this compound but at lower levels.
Men: Ask your doctor about taking a zinc supplement and saw palmetto extract. Both have some property to prevent or relieve prostate enlargement.
Type of Incontinence
four out of five cases of incontinence can now either be cured or made better. The first step is to identify which of the four classes is involved.
- Stress Incontinence
This type is associated with the weakness of the urinary sphincter, the circular valve-like muscle around the bladder neck, and the urethra that controls the urine flow. Coughing, laughing, etc., exert more pressure on the bladder than the sphincter can contain, and urine spills out.
Usual Causes: Abdominal or pelvic surgery, childbirth, estrogen deficiency, and certain drugs, including alpha-blockers and diuretic (water pill), make matters worse.
- Urge Incontinence
This form of incontinence occurs when overexcited nerves cause involuntary contraction of bladder muscles, causing a sudden urge to urinate but can’t reach a toilet in time.
Common Causes: Parkinson’s disease, multiple sclerosis, bladder, interstitial cystitis (bladder disorder), spinal cord problems, and chemotherapy.
- Overflow Incontinence
This incontinence happens when a weak bladder muscle or a urinary obstruction makes it hard to empty the bladder. Urine eventually overflows like water over a dam.
Most common causes: Diabetes, enlarged prostate in men, and prolapsed (dropped) bladder or uterus in women; The problem can also happen by over-the-counter colds, decongestant (pseudoephedrine), and allergy medication.
- Functional Incontinence
It is a temporary problem associated with stool impaction (chronic constipation), restricted mobility, vaginal irritation, and other conditions.
Bladder training aims to empty the bladder on a schedule so that urine won’t build up to the point where an accident occurs.
At first, urinate every 90 minutes and gradually lengthen the interval between trips to the bathroom for up to three hours until you find a safe and convenient schedule.
Helpful: A voiding diary for two to three days in a row, record how often you urinate and when leakage occurs. Review the journal with your doctor.
Most people with stress or urge incontinence get partial relief if they strengthen the urinary sphincter with these exercises.
- Identify the muscle you want to train, the same muscle used to control a bowel movement. If you have trouble identifying it, place a finger in your vagina (if you are a woman) or anus (if you are a man) and squeeze only the muscle around your finger.
- For the first three to six days, squeeze the muscle for three seconds at a time.
- Then over the next several weeks, gradually raise the squeezing time until you can tighten the sphincter for 10 seconds at a time. Relax the muscle for 10 seconds after each contraction. Do 50 every day.
Biofeedback and Weights
Biofeedback uses a unique tampon inserted in the vagina or rectum to help you identify the muscle that needs to be strengthened. The tampons are available by prescription.
Women with incontinence due to weak abdominal muscles can benefit from vagina weight training. Cone-shaped weights are held in the vagina for 15 minutes twice daily as you go about your daily activities.
Drug therapy brings faster relief than the nondrug approaches outlined above, but it often causes side effects.
Best approach: Start taking the medication when you begin bladder training, diet, and Kegel exercises. Gradually wean yourself off the drugs at the non-drugs method start to work.
- Oxybutynin (Ditropan), propantheline (Pro Bantinie), and tricyclic antidepressants like imipramine are good for stress and urge incontinence. Side effects include dry mouth, constipation, and dry skin.
- Diet pills containing pseudoephedrine are suitable for stress incontinence. Side effects include anxiety, insomnia, and sweating. Do not use it if you have high blood pressure.
The Surgical Option
Surgery may be the answer when other treatments fail to provide relief from incontinence. Several different forms of surgery are available, depending upon the exact nature of the problem and its severity.