Straight Talk for Women about Bladder Health
When it comes to health conditions that interfere with women’s daily life, urinary incontinence is up in the stress stratosphere. Running to the bathroom constantly. Leaking a little urine when you cough or pick up something heavy. Almost getting to the toilet on time…but not quite. Wearing bulky bladder control pads to protect against an embarrassing leak when not near a bathroom.
“The good news is that you don’t have to suffer,” says Cynelle Kunkle, M.D., urogynecologist at Crozer Health. “There are medications, therapies, devices, and minimally invasive surgical ways to stop urinary incontinence. The first step is to talk with a specialist who can diagnose your problem and recommend the best solution.”
Since November is National Bladder Health Month, here are a few top questions about why urinary incontinence occurs and what can be done about it.
Q: Why does urinary incontinence happen?
A: A woman’s bladder holds about two cups of urine. When it fills up, there’s an urge to urinate. Usually, people can “hold it in” until reaching the privacy of a bathroom.
But, when a small or larger amount of urine leaks out beyond your control on a regular basis, that’s urinary incontinence (UI).
While temporary causes of UI include things like urinary tract infections (UTI), pregnancy/childbirth, menopausal hormone changes, constipation, or medications, longer-term causes include the following:
- Weak or overactive bladder muscles
- Weak pelvic floor muscles
- Nerve damage from multiple sclerosis, diabetes, or Parkinson’s disease
- Pelvic organ prolapse (when the bladder, rectum, or uterus shifts toward the vagina, where they reduce the bladder and the urethra muscles’ ability to stop leakage)
- Hysterectomies or other surgeries
Q: What are the different kinds of UI?
A: There are three major types:
- Stress urinary incontinence (SUI) — When urine leaks from pressure put on the bladder, such as when exercising, coughing, sneezing, laughing, or lifting heavy objects. This is the most common among younger and middle-aged women. It can also begin around the time of menopause.
- Urge incontinence or overactive bladder (OAB) incontinence — When leakage occurs after a sudden need to urinate. This may be related to diabetes, Alzheimer’s disease, Parkinson’s disease, multiple sclerosis, or stroke.
- Overflow incontinence — When small amounts of urine leak over time from a bladder that isn’t completely emptied after urination. Symptoms range from a constant dripping or dribbling to frequently urinating just a small amount. Diabetes and spinal cord injuries can cause this type of incontinence.
Q: Can UI be cured?
A: Treatments vary, depending on the UI type:
- Bladder control training using Kegel exercises to increase pelvic muscle strength
- Biofeedback training that makes you more aware of the signals your body is sending when you have to urinate
- Timed voiding, which involves urinating at increasingly longer intervals to let you hold it in longer
- Lifestyle changes such as losing weight, quitting smoking, reducing caffeine and alcohol intake, preventing constipation, and avoiding activities like lifting that put pressure on your bladder
- Medications can control an overactive bladder, expand how much urine the bladder can hold, or help empty the bladder more completely during urination
- Minimally invasive surgery to support the pelvic organs and improve UI symptoms
Q: What options do I have if my UI is caused by pelvic organ prolapse?
A: Sometimes when the muscles and ligaments of the pelvic cavity are weakened by injury, age, hormones, or pregnancy/childbirth, this “pelvic floor” can’t hold the bladder, uterus, bowel, and rectum in their normal places. If the organs sink or bulge toward the vagina, that’s called pelvic organ prolapse. It can cause UI as well as constipation, fecal incontinence, pain during intercourse, and vaginal irritation.
One successful approach uses a soft, flexible silicone ring called a pessary. It is custom fitted by a doctor and worn inside the vagina to support the vaginal canal and the pelvic organs.
Q: What should I do next?
A: Talk with one of Crozer Health’s urogynecologists who specialize in pelvic floor problems that women develop.
“We’ll work closely with you to find the best options to regain control over your daily life,” says Dr. Kunkle. “Remember, you don’t have to suffer anymore with the discomfort, embarrassment, and inconvenience of urinary incontinence. There are fixes that really work.”