Help for Bladder Problems

By:    Medically Reviewed: Tom Iarocci, MD   Published: April 2, 2014

Incontinence affects a high percentage of U.S. adult women, but there are many ways to tame bladder issues without medication use or surgery.

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Urinary incontinence, or loss of bladder control, affects many adult women at some time in their lives. There are a variety of potential causes, but all involve an involuntary loss of urine. Often thought of as a problem only for older women, this assumption is incorrect. Many younger women report the problem too, especially after having a baby.

Another myth: "People think incontinence is a normal part of aging, and it certainly isn't," says Amy Rosenman, MD, health sciences clinical professor of obstetrics and gynecology at the David Geffen School of Medicine at UCLA.

 

Remedies are plentiful, ranging from dietary tweaks to medication and surgery. However, some women want to avoid medications and surgery and seek more natural approaches for taming incontinence. But these methods work best, Rosenman says, only if the problem is mild.

 

You can try some or all of the approaches, and if you don't get the relief you need, explore surgical and medical options next.

 

Incontinence 101

 

Doctors talk about two common types of incontinence: stress incontinence and urge incontinence.

 

"Stress incontinence is anatomic, related to pelvic floor muscle weakness and sometimes neurological damage to the pelvic floor," Rosenman says. You may lose urine when you laugh or sneeze.

 

In urge incontinence, or overactive bladder (OAB), the bladder muscles become too active, so you feel a strong urge to urinate — even if you just did. You may start to leak before you get to the toilet.

 

"There's a lot of overlap [of the two types]," says Rosenman, a urogynecologist who specializes in treating these conditions.

 

Non-Medical And Non-Surgical Options

 

For women who want to try non-medical, non-surgical options first, Rosenman and other experts suggest these methods:

  1. Tweaks in bodily intake: "Diet changes may help OAB," Rosenman says. Common trigger foods and drinks include caffeine, alcohol and very spicy foods. Avoid personal triggers of incontinence and increase fiber intake, as constipation can make things worse. Last but not least, take a close look at your fluid intake and the timing of drinks throughout the day. Though it’s essential to stay hydrated, studies show that slightly cutting back on fluids can help many OAB sufferers.
  2. Bladder retraining: If you have OAB, keep track of your bathroom visits throughout the day. Increase the interval between bathroom visits slowly, by about 15 minutes. When you are successful with that, increase the interval by another 15 minutes, and so on.
  3. Pelvic floor exercises: You probably know these as ''Kegels." Get proper instruction on how to do these — even if you think you know how — and be patient. "It takes one to three months for pelvic floor exercises to take effect," Rosenman says. "They have been shown to be substantially more effective when they are taught." Find a trained professional with experience in teaching these exercises for urinary incontinence, or ask your gynecologist to refer you to someone who can instruct you.
  4. Adding biofeedback to Kegels: In biofeedback, special instruments measure what the pelvic floor muscles are doing and display the activity on a computer screen. This feedback about muscle activity can enable better prevention of leaks. For even further benefit, combine biofeedback with Kegels, says Rosenman. In a study published in Neurourology and Urodynamics, researchers speculate that this might be related to having more contact with a health professional who can help an individual tune into her body.
  5. Electrical stimulation: In this technique, a small probe is put into the vagina and used to contract pelvic floor muscles electrically. The aim is to make the muscles become stronger.  

 

Next Steps

 

When deciding which treatment to approach, consider your lifestyle and your needs. Some women want to be totally dry, Rosenman says. For others, being somewhat drier is acceptable.

 

For instance, a woman who leaks only when she runs around the park with her toddler may decide to walk more slowly. Or perhaps that activity is so important to her, she’d prefer to do Kegels more frequently and rigorously.

 

If you've followed the treatment plan and don't experience enough relief, it may be time to consider medication or surgery, Rosenman says.

 

For Caregivers:

 

If a loved one suddenly becomes incontinent, it’s important to understand the cause, so encourage seeing a doctor. Also, consider the possibility that a loved one is suffering silently. If a loved one suddenly withdraws, especially from social outings, incontinence could be the reason.

  • Gently ask your loved one if there is a problem worth talking about.
  • If she acknowledges the issue of incontinence, relate that many women are affected: “You are not alone.”
  • If possible, offer to accompany her to a doctor to find out about options. 
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sources
  • Rosenman A., MD, urogynecologist and health sciences clinical professor of obstetrics and gynecology, David Geffen School of Medicine at UCLA. http://www.uclahealth.org/body.cfm?id=479&action=detail&ref=123571. Interviewed March 2014.
  • Harvard Health Publications. "How to Perform Kegel Exercises.” January 2011. http://www.health.harvard.edu/newsletters/Harvard_Womens_Health_Watch/2011/January/how-to-perform-kegel-exercises. Accessed March 2014.
  • Harvard Health Publications. “The Bladder Workout: Tame Incontinence Without Surgery.” February 2014. http://www.health.harvard.edu/healthbeat/the-bladder-workout-tame-incontinence-without-surgery. Accessed March 2014.
  • The American College of Obstetricians and Gynecologists. ''FAQ: Urinary Incontinence." May 2011. http://www.acog.org/~/media/For%20Patients/faq081.pdf?dmc=1&ts=20140306T1700573136. Accessed March 2014.
  • Herderschee R., Hay-Smith E., Herbison G., et al. "Feedback or Biofeedback to Augment Pelvic Floor Muscle Training for Urinary Incontinence in Women: Shortened Version of a Cochrane Systematic Review.” Neurourology and Urodynamics. 2013; 32 (4); pages 325-329. http://www.ncbi.nlm.nih.gov/pubmed/23239361. Accessed March 2014.
  • Urology Care Foundation. "Stress Urinary Incontinence.” http://www.urologyhealth.org/_media/_pdf/SUI%20Monograph%20New%20Logo.pdf. Accessed March 2014.
  • Hashim H., Abrams P. “How Should Patients With an Overactive Bladder Manipulate Their Fluid Intake?” BJU International. 2008; 102 (1). http://www.ncbi.nlm.nih.gov/pubmed/18284414. Accessed March 2014.
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