Bladder-Control Basics

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By News Team on January 24, 2022

It can happen at the most embarrassing times, and in the most inconvenient places. If you’re a woman who has urinary incontinence—loss of bladder control—you know how difficult it can be.

Urinary incontinence is also such a common problem that many women assume it’s an inevitable part of aging.

On the contrary: lifestyle changes and treatments can help minimize or even prevent it.

Taking Stock

How do you know if you have a problem? After all, many women notice occasional, small leaks of urine.

Often they occur when you laugh, cough or sneeze, putting pressure on your bladder. Urinary incontinence can also occur when you exercise or lift a heavy object. This is referred to as stress incontinence.

Other women experience urgency incontinence—a strong, sudden urge to urinate accompanied by an involuntary flow of urine. This can be the result of a minor problem like an infection or another medical condition such as diabetes.

Some women have urine leakage because their bladder doesn’t empty entirely. Or they have other physical problems that make it hard for them to get to the bathroom in time.

Common Causes

“Urinary incontinence is not just a normal part of aging,” said Natalie Karp, M.D., a urogynecologist with Carilion Clinic. “If urinary frequency, urgency or leakage is affecting your quality of life, you do have lifestyle and treatment options.”  

Some common drinks or foods, for instance, can act as diuretics or bladder irritants and increase your urine volume.

These include:

  • Caffeine
  • Chocolate
  • Carbonated drinks
  • Alcohol
  • Sparkling water
  • Chili peppers
  • Artificial sweeteners
  • Spicy or sugary foods
  • Foods high in acid, such as citrus fruits

Some medications for high blood pressure or heart conditions can also increase urine volumes.

Other risk factors can play a role, including:

  • Family history
  • Smoking
  • Excess weight
  • Diabetes
  • Neurological diseases
  • Sleep apnea

Aging can be a contributing factor when a woman’s urethra and bladder muscles weaken.

Treatment Options

Treatment options vary depending on which type of incontinence you have.

“For some women, making lifestyle changes such as reducing caffeine or fluid intake can help,” said Dr. Karp. “Others find that doing pelvic floor exercises with our specially trained pelvic floor physical therapists helps.”

For stress incontinence, there are both outpatient surgical procedures and non-surgical options using a vaginal insert called a pessary.

For urgency incontinence, in addition to lifestyle changes, oral medications are available, as well as procedures involving Botox injections or nerve stimulation. The Botox procedure involves inserting medication into the bladder wall using a tiny needle to relax the bladder muscle.

The Botox option is recommended for women who have experienced side effects from medications or who haven’t been helped by other treatments.

Nerve stimulation treatment options target the nerve supply to the bladder. These include sacral neuromodulation, which acts like a pacemaker for the bladder, and tibial nerve stimulation, which is an in-office procedure using a tiny needle in the lower leg.

So if you are suffering from urinary incontinence, it can help to know that you do have options.

And while you can’t do anything about aging, exploring all your options can help to vastly improve your quality of life.

Should your gynecologist also be your main doctor?
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