Column: Hometown Health, by Fadi Yahya

What is urinary incontinence?

This is when a person loses bladder control and leaks urine. The three most common types of incontinence are:

• Stress incontinence: People with stress incontinence leak urine when they do anything that “stresses” the belly (e.g. cough, sneeze, laugh).

• Urgency incontinence: People with urgency incontinence feel a strong need to urinate all of a sudden and can’t make it to the bathroom in time.

• Mixed incontinence: People with mixed incontinence have symptoms of both stress and urgency incontinence.

This is a very common problem and is not a normal part of aging. Many people are hesitant to discuss this with their health care provider. This article has some suggestions that can help people with mild symptoms.

 

When to see a doctor?

If incontinence is frequent or is affecting your quality of life, seeking medical advice is important for several reasons:

Urinary incontinence may indicate a more serious underlying condition, especially if it’s associated with blood in your urine.

Urinary incontinence may be causing you to restrict your activities and limit your social interactions to avoid embarrassment.

Urinary incontinence may increase the risk of falls in older adults as they rush to make it to the toilet.

 

What can you do on your own to help control or eliminate symptoms?

• Avoid excessive fluid intake, especially before bedtime.

• Avoid foods that can irritate the bladder (Caffeinated beverages, alcohol, carbonated drinks, smoking, tea and coffee — with or without caffeine — artificial sweeteners, corn syrup, and foods and beverages that are high in spice, sugar and acid, such as citrus and tomatoes).

• Weight loss is effective for overweight and obese people.

• Take good care of medical conditions such as diabetes.

• Understand if your medicines can increase the need to urinate, and take them when you know you will be near a bathroom (e.g. Heart medications, blood pressure drugs, sedatives, muscle relaxants and other)

• Avoid and treat constipation.

 

What exercises can help improve bladder control?

1. Pelvic floor muscle exercises: These exercises strengthen the muscles that help control urination. First try to find the right muscles. To identify the correct muscles, stop urination in midstream. If you succeed, you’ve got the right muscles.

Once you’ve identified your muscles, empty your bladder and tighten the muscles, hold the contraction for five seconds, and then relax for five seconds. Try it four or five times in a row. Work up to keeping the muscles contracted for 10 seconds at a time, relaxing for 10 seconds between contractions.

For best results, focus on tightening only your pelvic floor muscles. Be careful not to flex the muscles in your abdomen, thighs or buttocks. Avoid holding your breath. Instead, breathe freely during the exercises. Repeat three times a day. Aim for at least three sets of 10 repetitions a day.

2. Bladder retraining: The goal is to lengthen the time between trips to the toilet until urinating at normal intervals. Two techniques can help achieve that goal. Control urges to urinate: Try to suppress the urge by standing or sitting still, relaxing, breathing slowly, performing a pelvic muscle exercise, and thinking of the urge as a wave that is fading away. Scheduled toilet trips.

Begin by going to the bathroom at specific intervals during the day, starting with a small time interval. For example, if you currently go to the bathroom every hour, you would start by going every hour, whether you feel the need to go or not. And you would try to wait until a whole hour had passed if you needed to go sooner. Many people can start by going every one to two hours.

When your urine control improves, increase the time between bathroom trips by 30 to 60 minutes. The goal is to slowly increase this time up to around four hours.

 

What treatments are available through your health care provider?

The treatment options differ depending on what type of incontinence you have, and whether you are a man or a woman. Some of the treatment options include:

• Medicines to relax the bladder.

• Surgery to repair the tissues that support the bladder.

• Electrical stimulation of the nerves that relax the bladder.

A more detailed discussion of urinary incontinence is available through the Mayo Clinic website.

 

Fadi Yahya, M.D., OB/GYN, practices at Mayo Clinic Health System in Albert Lea. To schedule an appointment with him, call 379-2131.