Embarrassed about urine leaks? We talk bladder training and lifestyle changes to combat incontinence
Urinary incontinence refers to the accidental passing of urine. It is a common condition, that is more prevalent among women than men and can occur when you laugh, cough or sneeze. But dealing with urinary incontinence in your day-to-day life can be embarrassing, uncomfortable and debilitating.
What is urinary incontinence?
The NHS states urinary incontinence is the accidental passing of urine. The two most common types of incontinence are stress incontinence and urge incontinence.
Urine leaks can strain intimacy between you and your partner, and impact your performance at work. If you have to make frequent trips to the toilet during the night as a result of urinary incontinence, it can leave you feeling tired and frustrated during the day. The fear of experiencing a urine leak can also cause you to withdraw from social activities, which often leads to feelings of isolation.
Stress incontinence
Although its name suggests otherwise, stress incontinence does not happen in response to feeling stressed. It occurs when urine leaks out of your urethra (the tube that allows urine to leave your body) due to sudden pressure on your bladder. This can be caused by exercise or heavy lifting. But simple actions such as sneezing, laughing or coughing can also trigger stress incontinence.
Urge incontinence
Urge incontinence is characterised by a sudden and urgent need to urinate. It may cause you to leak urine before you have reached the toilet. According to the NHS, urge incontinence often occurs with condition known as overactive bladder syndrome. This condition means your bladder muscles are more active. You may experience nocturia, with urge incontinence, where you wake up several times during the night to pass urine.
What are the causes of incontinence?
There are many causes of incontinence, including:
Damage to your pelvis
Weakened or damaged pelvic floor muscles can interfere with your urethra's ability to remain closed and not leak urine.
Damage to your pelvic floor muscles can occur due to child birth, pressure on your abdomen due to obesity or pregnancy, or bladder damage due to surgery such as a hysterectomy (the removal of your womb).
The NHS adds neurological conditions such as multiple sclerosis and specific medications can cause problems with your pelvic floor muscles.
Damage to your urethral sphincter
If your urethral sphincter (the muscle that keep your urethra closed) is damaged, it can cause stress incontinence and urine to leak from your urethra.
Problems with your detrusor muscles
When your detrusor muscles (the muscles in the walls of your bladder) relax, your bladder fills with urine. Urine then exits your body through your urethra when these muscles contract.
However, if your detrusor muscles frequently contract, it can trigger urgent trips to the toilet (urge incontinence).
This is referred to as an overreactive bladder. There are many possible reasons for increased contractions in your detrusor muscles, from a high alcohol or caffeine intake, to constipation or not drinking enough water. Urinary tract infections, bladder tumours and neurological problems can also lead to increased contractions in these muscles.
Urine leaks can strain intimacy between you and your partner, and impact your performance at work.
Treatment options and lifestyle changes for incontinence
There are many ways you can treat incontinence, from prescribed treatment to lifestyle changes, to products that help you manage your symptoms effectively.
Lifestyles changes can be effective
Lifestyle changes such as lowering your intake of caffeine can alleviate incontinence by reducing the amount of urine that your body produces.
Weight loss could also help you manage your incontinence. If you are overweight or obese, fatty tissue to put pressure on your bladder. This can lead to weakened pelvic floor muscles, which in turn can trigger urinary incontinence.
The NHS states your GP will recommend these lifestyle changes, regardless of the type of incontinence you have.
Incontinence products help you manage symptoms
Incontinence products are not an 'instant fix' for urinary incontinence. But they can help you manage your symptoms better.
Incontinence pads
Incontinence pads absorb urine and can be worn inside your underwear. They consist of a hydrophobic layer that moves urine away from the pad's surface, and keeps your skin dry.
For mild to moderate urine leaks, you can purchase pads from your local supermarket or pharmacy. However, if you have severe incontinence, your local continence clinic can provide an appropriate absorbent pad to support your needs.
Incontinence bedding
Washable bed pads work by absorbing any urine leaks that can happen during your sleep. You can put these bed pads on top of your mattress at home, or lift them off to take with you for overnight stay elsewhere.
Bladder retraining
Bladder retraining helps increase the duration between your urge to urinate and going to the toilet. By doing so, it encourages you to hold your urine inside your bladder and reduces excessive trips to the toilet. Other benefits of bladder retraining include instilling better toilet habits and minimising incidents of wetting yourself.
Your Consultant might combine bladder retraining with pelvic floor muscle training or rehabilitation.
Pelvic floor rehabilitation
Your pelvic floor muscles are responsible for keeping your pelvic organs such as your bladder, bowel and prostate or uterus in the right position. These muscles help ensure the openings to your bladder and bowel are kept closed to prevent unwanted leaks (faecal or urinary incontinence).
Pelvic floor exercises can strengthen these muscles and prevent urine leaks. You might be referred by your GP to a specialist for pelvic floor rehabilitation. During your consultation, your consultant will carry out an assessment of your pelvic floor muscles to see whether you can contract or relax your muscles.
Your consultant will then create a programme of exercises tailored to your needs. You should repeat these exercises for a minimum of three times a day for at least three months.
Electrical stimulation
If your assessment shows that you cannot contract your pelvic floor muscles, your consultant may recommend electrical stimulation.
As part of this procedure, a probe is inserted into your vagina or anus (for men) and an electrical current is passed through this probe. This electrical stimulation helps strengthen your pelvic floor muscles during exercise.
Seeking help for urinary incontinence with Circle Health Group
If you're struggling with urinary incontinence, you can speak to one of our consultant urologists by contacting a member of our team or booking an appointment online.
Alternatively, if you would like to speak to a physiotherapist about pelvic floor rehabilitation for incontinence, you can contact a member of our team.
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How do I book an appointment?
If you're concerned about symptoms you're experiencing or require further information on this subject, talk to a GP or see an expert consultant at your local Circle Hospital.