Managing Urge Incontinence

Have you seen that cute commercial with the little red “bladder” character who pesters the woman until she takes it to the bathroom?  Imagine that little guy just grew horns and a bad attitude.  It doesn’t pester.  It gives one warning and then unless she finds a bathroom RIGHT NOW it makes an embarrassing mess all over.

That’s urge incontinence.

Frequent urination.  Strong urges which quickly morph to an irresistible urge to void. Accidents.  Getting up at night frequently to pee.

Can you imagine if this was you?  Wouldn’t you be hesitant to leave the house?  I would.  It would be hard to go to the grocery store or do any other shopping, go to church, or function at work, let alone travel anywhere.

It’s hard to turn on the TV anymore without seeing ads for adult briefs and constipation products.  The large number of such ads would make it easy to assume this is a “normal” part of aging.  But it’s not.  Urge incontinence is NOT normal.  And it is definitely treatable.

My friend and colleague Dr. Holly Wyneski is a urologist in practice in Richfield, Ohio.  She specializes in female pelvic and bladder problems.  I reached out to her to get a little information about management of urge incontinence.   Please check out her website at www.hollykaywyneskimd.com 🙂

When dealing with urge incontinence, Dr. Wyneski’s advice is to start with behavioral change.  First, take a close look at diet (including fluid intake) and avoid foods and beverages that irritate the bladder.  Dr. Wyneski’s website has a list you can download here.  Examples include alcohol, caffeine, carbonated beverages and spicy and acidic foods.  Next, do your best to get enough sleep, and be aware of your stress level.  In addition to helping with stress and sleep, a number of my patients have found that magnesium supplementation helps calm the bladder.

In addition, your weight also influences how well your bladder works.  (Go figure, right?  Your weight affects everything ELSE in your body so why not your bladder!)  If you are overweight or obese, losing as little as 5-10% of your body weight can go a long way towards getting your bladder working better.

If the above measures don’t correct your bladder problem, bladder training is a very important behavioral treatment.  This starts with listening to your body.  Dr. Wyneski advises that you should empty your bladder every 2-3 hours.  It is also not considered abnormal to get up one time at night for every decade over age 70.  If you’re drinking enough fluids you will need to go at least that frequently.

Are you holding your bladder for 5-6 hours?  (HELLO all my nurses and teachers out there!)  If so, you are setting yourself up for problems down the road.  If the bladder gets stretched out it will get weak and not empty as well as normal.  This can lead to incomplete emptying (where there is still urine left in the bladder after voiding) and can cause infections and kidney damage.

The other side of the coin is the overactive bladder, where every time the bladder gets a little urine in it you feel like you need to go.  People with overactive bladder may need to go every hour, or even more often.  If you know every gas station with a clean bathroom on the east side of the city, this may be you!

Some people are very sensitive to the “stretch” sensation and may feel they need to go even if it’s not needed.  You may also have a bladder that tends to spasm and contract when it’s not time to go.  Men may have problems with their prostate that make it feel as if they need to go more frequently than normal.

Bladder training for the overactive bladder consists of waiting a few minutes after it feels like you need to go.  This will gently “stretch” the bladder and de-sensitize the urgency sensation.  Even starting with just a two-minute timer will make a difference.  You can gradually lengthen the time you wait.  It takes patience, but it is so important!

If these behavioral changes don’t help, please see your doctor.  Also, if you develop sudden bladder symptoms you should see the doctor, this may be an infection that needs treated right away.

If you’re like the woman in the commercial and you feel like you’re a prisoner of your bladder, there are things you can do to improve your symptoms yourself.  Your doctor can help too, and if all else fails, urologists like Dr. Wyneski have got lots of tools in the toolbox!

QUESTION: Do you have problems with your bladder?  What has helped you?

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