Download Urinary Incontinence - Patient Education Center

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Other treatments. The sacral nerve at the bottom of your
spine reminds your bladder “not to go” until it is full.
Several treatments aim to improve this “hold it” signal
in order to relieve overactive bladder. Botox—the same
medicine used to treat cosmetic wrinkles—is an option for
relaxing a severe overactive bladder. Injections of “bulking
agents” can help some forms of stress incontinence by
shoring up the outlet muscles.
Written by
Harvard
Resources
Medical School
National Association for Continence
P.O. Box 1019
Charleston, SC 29402
800-252-3337 (toll-free)
www.nafc.org
American Urological Association
1000 Corporate Blvd.
Linthicum, MD 21090
866-746-4282 (toll-free)
www.urologyhealth.org
Surgery. Many procedures for incontinence are now
relatively quick and require less recovery time. Often,
surgery can be done on an outpatient basis or even in the
doctor’s office. The decision to have surgery is a personal
one with no right or wrong answer. You may consider
surgery if other treatments are unsuccessful or unlikely
to help your type of incontinence. Even if you opt for
surgery, bladder training and strengthening your pelvic
muscles still provide important benefits. They increase
the chances that surgery will be successful. If you decide
to have surgery, be sure that your surgeon is highly
trained and experienced in the procedure you need.
Urinary
Incontinence
Living with your bladder
Whether your bladder control problems are mild or severe,
it can be a frustrating problem to deal with. Although you
may feel alone, help is available from many sources. Simply
getting treatment can greatly improve well-being, even if
symptoms don’t improve much.
A therapist can help you cope with
your emotions and the stress of
treatment. And don’t be afraid
to tell friends and family.
You’d be surprised how
many other people—both
men and women—have
experienced some form of
urinary incontinence. A support
group can link you to others
who are going through the
same experience and can
offer practical advice and
emotional support.
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& Harvard Medical School
Patient Education Center
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Fort Dodge, IA 50501
[email protected]
About This Brochure: This brochure was written by practicing physicians
from Harvard Medical School. It is part of a series developed and distributed
by the Patient Education Center. All the information in this brochure and on
the associated Web site (www.patientedu.org) is intended for educational use
only; it is not intended to provide, or be a substitute for, professional medical
advice, diagnosis, or treatment. Only a physician or other qualified health care
professional can provide medical advice, diagnosis, or treatment. Always consult
your physician on all matters of your personal health. Harvard Medical School,
the Patient Education Center, and its affiliates do not endorse any products.
Consulting Physician: Anthony L. Komaroff, MD
Editorial Director: Keith D’Oria
Creative Director: Jon Nichol
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Common types of
urinary incontinence
Bladder control problems occur more often in women.
Why? Pregnancy and childbirth can damage the muscles that
support the bladder (the pelvic floor). Shifting
hormone levels at menopause is another
cause. For men, prostate problems and
their treatment can also lead to bladder
control problems. Aging, medications,
nerve damage, and health
problems (eg, diabetes) can trigger
incontinence in both sexes.
Stress incontinence results when the pelvic floor is weak or
when the outlet muscles aren’t strong enough to con­trol
urine flow. Stress incontinence is common in women who
have had many children and in men who have had prostate
surgery. A cough, a sneeze, or an exercise in­creases pressure
on the bladder, forcing urine to leak out.
ost people take bladder control for granted,
but that may change if urine leaks when you
don’t expect it, or if you find yourself needing
the bathroom a lot. Urinary incontinence is the accidental
loss of urine, and it’s a condition that’s far more common
than you might think.
A person with bladder control
problems may start to plan his
or her day around access to
a bathroom or give up their
favorite activities, such as
exercise, social events, and travel.
If this is happening to you, learn
about treatments that can cure or
greatly improve your symptoms.
Your bladder
Your kidneys are constantly making urine, but you don’t
want to be constantly urinating. To allow you to urinate
just occasionally, nature gave us bladders. Your bladder is
a hollow organ that stretches to hold urine coming from
your kidneys. As the bladder gets nearly full, you’ll feel the
need to use the bathroom. Your nervous system controls
when you urinate by activating two key muscle groups:
1) the bladder wall muscle squeezes (contracts), and 2) the
muscles at the bladder outlet relax, allowing urine to pass.
Good bladder control requires three things:
1. The muscle in the walls of the bladder can’t contract
too soon.
2. The muscles at the outlet of the bladder need to
control the flow.
3. The pelvic floor must support the bladder.
Urge incontinence (“overactive bladder”) is most common
in older adults. It occurs when the bladder wall muscle
suddenly contracts before the bladder is full. The result
is a strong urge to urinate. Often, a little bit of urine will
leak before a person can get to a bathroom.
Mixed incontinence occurs most often in older women
and is caused by a combination of urge incontinence
and stress incontinence.
Overflow incontinence happens when the bladder gets too
full. The cause is usually a problem in fully emptying the
bladder in the first place. Men with an enlarged prostate
may have this type of incontinence. Symptoms include
dribbling of urine and urinating often, usually with small
amounts coming out each time.
Don’t let shame keep you from
seeing your doctor about bladder
control problems.
What type of incontinence
do you have?
Don’t let shame keep you from seeing your doctor
about bladder control problems. These talks with
your doctor can help figure out what is causing your
incontinence and lead to potential treatment. You can
help by keeping a written record of when you urinate.
A pelvic exam is important for women; for men, a
prostate exam may be of help. Tests might include
checking your urine for infection and blood tests to
check your kidneys and overall health. Your doctor
might also suggest other tests.
Treatment
Treatment options for urinary incontinence range from
simple steps you can take at home to surgery. Your
treatment will depend on the cause of your bladder
control problems. No treatment works perfectly, so
you may need to try several.
Kegel exercises. Kegels are often the place to start
for urge and stress incontinence. Practice tightening
the muscles you would use to stop the flow of urine or
rectal gas. Your doctor can give you specific instructions
on doing Kegels.
Bladder training. By following a program of urinating
on schedule, bladder training helps you slowly increase
the amount of urine you can comfortably hold.
Watch your fluid intake. Drink fluids only when you
feel thirsty, and stick to six to eight 8-ounce cups of
fluid per day (including soup or milk in your cereal)
unless you have a health condition that requires
more. Stay away from caffeine and alcohol. They
can cause your body to produce more urine.
Drugs. A number of drugs can help
with incontinence symptoms. Some
relax muscles in the bladder and the
outlet muscles and some tighten those
muscles. Some act on the nerves in
the bladder, while others can help
control the amount of urine your
body produces while sleeping. Your
doctor may recommend one of these
drugs based on your type of bladder
control problem.