Bladder control problems are very common, over 160,000 adults experience urine leakage twice or more a month. The production of urine is not under our control, but as adults we have the ability to recognise when the bladder is full, and are able to hold on until we reach the toilet.
We therefore have control over where and when we will pass urine. This control is as a result of messages being passed from our bladder to our brain and our ability to interpret these messages. With this control, we are said to be continent. Incontinence is a symptom when one of the mechanisms which keeps us dry is not working correctly. How incontinence is experienced varies, according to the reason of what is causing it.
It is therefore important to seek professional help to determine the cause and access appropriate treatment. Help can be sought from your GP, Physiotherapist or Continence Advisor. It is more common to experience bladder control problems in older people.
Types of incontinence:
- Stress incontinence - the involuntary loss of urine when pressure inside the abdomen is increased by activities such as running, lifting, sneezing and laughing
- Urge incontinence - this is the sudden and strong urge to pass urine. If a person is unable to get to the toilet in time, and experiences involuntary loss of urine, it is said that the person has 'urge incontinence.
- Overflow incontinence - when a small amount of urine leak from a bladder that is always full. A man can have trouble emptying his bladder if an enlarged prostate is blocking the urethra. Diabetes and spinal cord injuries can also cause this type of incontinence.
- Functional incontinence occurs in many older people who have normal bladder control. They just have a problem getting to the toilet because of arthritis or other disorders that make it hard to move quickly.
70% of women with stress incontinence can become dry or improve significantly by doing pelvic floor exercises. Only a small number of women would require surgery. Most urge incontinence can be corrected by bladder retraining, sometimes combined with medication.
Bladder retraining is a simple and effective method to help regain normal bladder control. The purpose of this type of retraining to suppress or ignore the desire to pass urine, so that a more normal patterns is achieved without the urgency or leakage. The results are gradual and may take up to 3 months or more. Find out more about bladder retraining:
- Continence NZ
- A Continence Advisor, who is accessible through your local hospital or health agency will be able to assist you further.
Pelvic floor exercises
The pelvic floor is a funnel shaped group of muscles stretching from the pubic bone in the front to the tail bone. These firm supportive muscles form the floor of the pelvic cavity and so are called the pelvic floor. They provide support for the bladder, uterus and bowel and to close the bladder outlet and back passage. Pelvic floor muscle activity can be likened to the action of a trampoline in that while it is released during bowel and bladder emptying, it 'springs back' on completion. Exercises can help strengthen these muscles. This may improve your bladder control and improve or stop leakage or urine. Further information on pelvic floor exercises is available at the website of Continence NZ
Managing urinary incontinence
Besides bladder control training, you may want to talk to your doctor about other ways to manage incontinence which could include:
- Medicines can help the bladder empty more fully during urination. Other drugs tighten muscles and can lessen leakage
- Some women find that using an estrogen vaginal cream may help relieve stress or urge incontinence.
- A doctor may inject a substance that thickens the area around the urethra to help close the bladder opening to help with stress incontinence in women.
- Surgery can sometimes improve or cure incontinence if it's caused by a change of position of the bladder or blockage due to an enlarged prostate.
Even after treatment, some people still leak urine from time to time. There are bladder control products and other solutions, including adult diapers, furniture pads, urine deodorising pills and special skin cleansers that may make leaking urine bother you a little less.
I Can't Wait card
Finding a toilet when out and about can be a challenge for people with bladder or bowel problems. It could even discourage some people from going out altogether. Crohn's & Colitis New Zealand has a toilet card which clearly states that the holder has a medical condition and needs to use a toilet quickly. Most places you visit will be willing to help you. Contact Crohns & Colitis New Zealand for a card.
Incontinence: the taboo hurting the dignity and health of millions (UK)
Ten organisations including Alzheimer's Society, Age UK, Marie Curie and Parkinson's UK held a workshop to discuss common problems and potential solutions with patients, carers, researchers and health and social care professionals. The resulting report "My bladder and bowel own my life." recommends tackling the stigma and funding research into this important but often ignored issue.
Quick reference guide
- Always seek medical advice if you are having trouble with your bladder or bowels: see your doctor, Continence Nurse, Continence Physiotherapist through the local community health service, or contact Continence NZ on 0800 650 659.
- Drink at least 1 litre of fluids per day (excluding tea and coffee)
- Try pelvic floor exercises to strengthen your muscles
- Try some of the continence products: Pharmacy, supermarket, Continence Products distributors.
Websites of interest