Know how to manage bladder incontinence

All these scenarios are symptoms of bladder incontinence, the loss of bladder control. Leaky bladders and overactive bladders happen at inconvenient times, like during grocery shopping, meetings or exercise.

UW Health can help.

What causes bladder incontinence and urinary leakage?

Stress incontinence and overactive bladder (urge incontinence) are the two main types of incontinence. Many people have both.

With stress incontinence, the bladder leaks when you:

• Cough or sneeze

• Exercise

• Laugh

• Lift something heavy

• Play sports

This is because the stomach muscles tighten and put pressure on your bladder, causing urine to leak. It's even more likely if your pelvic floor muscles are too weak to support the bladder and urethra — the tube that carries urine from the body.

Causes of stress incontinence can include:

• Excess weight

• Injury

• Pregnancy and childbirth

• Surgery

If you have an overactive bladder, you might feel:

• A sudden, strong urge to use the bathroom

• The urge to urinate frequently during the day and overnight

• Sometimes, overactive bladder happens because the nerves and muscles don’t interact properly to hold urine in the bladder.

Other causes include:

• Alcohol

• Caffeine

• Drinking too much liquid

• Infection

• Medication

• Older age

• Spicy foods

How can people treat bladder incontinence without surgery?

All aspects of your health and lifestyle should be considered when trying to improve bladder control.

• Avoid food and drinks that irritate the bladder. Limit spicy foods, carbonated drinks, citrus fruit and juices.

• Avoid alcohol and caffeinated drinks that could stimulate the bladder.

• Ask your doctor if you’re drinking the right amount of water. The National Academies recommends nine cups of liquid per day, but this amount is not healthy for all people.

• If you have diabetes, control your blood sugar. High blood sugar levels lead to nerve damage and bladder issues.

• Maintain a healthy weight.

• Stop smoking to reduce coughing and cancer risk.

Exercise to improve bladder control

Try Kegel exercises by tightening and relaxing the muscles that control urine flow. These exercises strengthen the pelvic floor muscles that support your bladder. Yoga and Pilates also strengthen your muscles.

Bladder training

Bladder training involves delaying urination, even when you feel the urge to go, and using the bathroom on a set schedule. You can gradually lengthen the time between bathroom trips to stretch the bladder so it holds more. When you feel the urge to urinate before the scheduled time, try relaxation techniques, such as deep breathing.

A doctor or physical therapist can create a bladder training program that works for you and show you how to perform helpful exercises and relaxation techniques.

Insertable devices

Your urogynecology provider can fit you with a pessary — a special vaginal insert. The pessary supports your bladder and puts pressure on the urethra so you don’t leak. You can also buy a disposable, over-the-counter device that you insert and remove like a tampon. It gently supports the urethra to stop the flow of urine that happens with stress incontinence (when you cough, sneeze or exercise). Your doctor can recommend the best product and help you find the right fit.

Medicine

Certain medicines can relax the bladder muscle to control the urge to urinate.

Medical procedures for incontinence

If nonsurgical treatments don’t improve bladder control, your doctor may suggest a minimally invasive surgical procedure.

A sling or bulking agent

Possibilities include

• A mesh sling placed under the urethra, the tube that carries urine from the body, to support it when a person exercises, sneezes or coughs.

• Injection of a bulking agent near the urethra, which narrows the tube and reduces the likelihood of leakage

Some patients need more extensive support to stop stress incontinence. Doctors also can create a sling out of the patient’s body tissue to hold up the vagina and support the urethra.

Other incontinence treatments are available for overactive bladder, and include:

• Botox: Botox injections inside the bladder relax the bladder muscle and reduce urinary leaking associated with urgency or frequency.

• Neuromodulation: A patient may come to the office for ankle stimulation, or a surgeon implants a device in the lower back to stimulate the bladder nerves to work correctly.

• Catheter: A patient can learn to insert a catheter that drains the bladder periodically if it does not empty completely and causes overflow leaking.

Why seek bladder incontinence care at UW Health?

At UW Health, we provide expert care and understanding, along with the latest, most effective treatments to manage bladder incontinence.

If you need help with incontinence, call (608) 914-0800 to schedule an appointment.