Bladder leakage, also known as urinary incontinence, is a common but often misunderstood condition that refers to the unintentional leakage of urine. About 25 million people in the United States have experienced bladder leakage before, and while it is more common in women, it can affect men as well.
“Upwards of 50% of women experience it,” says Sara Lenherr, MD, a urologist at University of Utah Health. “It’s a quality-of-life issue so people don’t always report it, but it is more common than people realize.”
Bladder leakage can be an embarrassing and frustrating issue to deal with, but you don’t have to live with it forever. Understanding your symptoms can help point you to the underlying condition that is causing your incontinence and available treatments.
Pinpointing the Cause
Bladder leakage itself is not a disease, but a symptom of other issues.
The first step to understanding what may be causing your leakage is knowing what kind of incontinence you are experiencing. Two of the main types are:
- Urge incontinence: Also referred to as overactive bladder, this is a strong urge to urinate that comes on so suddenly that you may not make it to a bathroom in time.
- Stress incontinence: The leakage of urine when coughing, sneezing, laughing, exercising, or lifting heavy objects. Stress incontinence can range from just a few drops to enough urine to soak through clothes.
“When people come in for an evaluation, it’s useful to identify if it’s stress leakage, urgency leakage, or both. If it’s both, I’ll ask which type causes them to have to change their lifestyle more because this is a quality-of-life issue.”
Both men and women can experience bladder leakage. Some of the most common issues include:
- Age: As people get older, muscles in the bladder and urethra can weaken.
- Obesity: Excess weight can put pressure on the bladder.
- Neurological disorders: Parkinson’s, multiple sclerosis, stroke, and spinal cord injuries can cause interference with the nerve signals that control the bladder.
- Chronic coughing: Conditions that cause frequent coughing, such as bronchitis or asthma, can put strain on the pelvic floor muscles.
- Menopause (women): The decrease in estrogen production during menopause can weaken the pelvic floor muscles.
- Pregnancy and childbirth (women): Hormonal changes and weight of the baby during pregnancy can cause incontinence. Delivering a baby vaginally can put significant strain on the pelvic floor muscles, or lead to prolapse. Prolapse occurs when organs such as the uterus or bladder get pushed into the vaginal canal.
Knowing Your Treatment Options
Treatment for bladder leakage will depend on its severity and what’s causing it. But rest assured that there are options to solve this problem.
Stress Incontinence Treatments:
- Lifestyle changes such as weight loss, quitting smoking, reducing caffeine and alcohol intake, and stopping excessive drinking of fluids.
- Pelvic floor exercises, also known as Kegels, which can be especially helpful for people who have just given birth.
- Wearing absorbent pads or underwear.
- Medical devices such as urethral inserts or catheters can help manage leaks. For women, a flexible silicone ring called a pessary can be worn in the vagina to support the structure of the pelvic floor and treat prolapse.
Urge Incontinence Treatments:
- The same lifestyle changes recommended for stress incontinence.
- Pelvic floor physical therapy.
- Avoiding bladder irritants.
- Medications that can help relax the bladder or increase its capacity.
- Botox injections into the bladder.
- Posterior tibial nerve stimulation.
- Sacral neuromodulation.
If these treatments aren’t working and stress urinary incontinence is still negatively affecting your life, surgical options do exist:
- Urethral bulking: This procedure involves an injection of a filler in the urethra. This creates more resistance to avoid urine leakage with activity.
- Sling procedure: A sling is created from synthetic mesh or tissue from your body to help support the bladder neck and keep the urethra closed.
- Artificial urinary sphincter: This device is mainly used to treat men experiencing incontinence. It involves a cuff that wraps around your urethra to keep it closed, a pump in the scrotum, and a balloon in the abdomen to regulate the flow of fluid.
Lenherr recommends seeing a doctor right away if blood is present in your urine or you experience pain associated with urinating. But ultimately, bladder leakage is a quality-of-life issue that you can treat.
“If you’re bothered by it, ask to see a urologist,” Lenherr says. “It can be treated in most people very successfully, especially if we get started on some therapies early.”
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