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Urinary Incontinence When Standing Up

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According to the Urology Care Foundation, women are at greater risk for UI than men because they have a shorter urethra than men. As a result, any weakness or damage to the urethra in a woman is more likely to cause urinary incontinence. This is because there is less muscle keeping the urine in your bladder until you are ready to urinate.

Alternative And Complementary Therapies

The treatment of urinary incontinence varies depending on the cause of the bladder control problem. In most cases, a physician will try the simplest treatment approach before resorting to medication or surgery.

Bladder Habit Training This is the first approach for treating most incontinence issues. The goal is to establish a regular urination schedule with set intervals between urination. A doctor will usually recommend urinating at one-hour intervals and gradually increasing the intervals between urination over time.

Pelvic Muscle Exercises Also called Kegel exercises , this exercise routine helps strengthen weak pelvic muscles and improve bladder control.

The person contracts the muscles used to keep in urine, holds the contraction for 4 to 10 seconds, then relaxes the muscles for the same amount of time.

It may take weeks or months of regular pelvic exercise to show improvement.

Another way to perform Kegel exercises is to interrupt the flow of urine for several seconds while urinating.

What Is Poor Bladder Control

People with poor bladder control may:

  • Have accidents and leak urine. This is called urinary incontinence
  • Need to hurry to get to the toilet to pass urine
  • Wet themselves before they can get to the toilet
  • Go to the toilet often through the day
  • Be woken up more than once a night by the need to empty their bladder
  • Leak urine when they get up from a bed or chair
  • Leak urine when they lift, laugh, cough or sneeze wet themselves and be unaware of it
  • Have a stream that stops and starts instead of a smooth flow wet the bed.

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Other Types Of Incontinence

Overflow, functional, and transient incontinence, as well as bedwetting, are other types of incontinence, according to MedlinePlus.

Overflow incontinence happens when you have too much urine in your bladder. Functional incontinence occurs when urine leaks as a result of disabilities or other physical problems. Transient incontinence occurs when something causes the incontinence but disappears when the cause is eliminated. Bedwetting happens exclusively when someone leaks urine while asleep.

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To dispel misconceptions, a urogynecologist discusses the surprisingly common, lingering issue many women experience.

Bladder leakage. For some women, the condition runs their life from the inside, preventing them from playing outside with their kids, going to a workout class or staying the night with family or friends.

And theyre not alone. Living with some degree of urinary incontinence, defined as an uncontrolled leakage of urine, is actually common, according to Pamela Fairchild, M.D., a urogynecologist at Von Voigtlander Womans Hospital at Michigan Medicine.

She says that approximately half of all women over the age of 20 experience some degree of incontinence. This means urinary incontinence isnt just an issue that affects elderly or postpartum women, although aging and childbirth are risk factors.

But if so many women experience it, then why does the topic still seem embarrassing?

Women get the sense that this is inevitable, that its a natural part of aging and they have to live with it, says Fairchild. This false perception leaves women feeling powerless, even though there are ways to greatly improve their quality of life.

To help overcome the stigma, Fairchild shared three facts about urinary incontinence that all women should know.

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How Urinary Incontinence Is Treated

Initially, your GP may suggest some simple measures to see if they help improve your symptoms. These may include:

  • lifestyle changes, such as losing weight and cutting down on caffeine and alcohol
  • pelvic floor exercises taught by a specialist
  • bladder training guided by a specialist

You may also benefit from the use of incontinence products, such as absorbent pads and hand-held urinals .

If you are still unable to manage your symptoms, medication may be recommended.

Surgery may also be considered. The specific procedures suitable for you will depend on the type of incontinence you have.

Surgical treatments for stress incontinence, such as tape or sling procedures, are used to reduce pressure on the bladder, or strengthen the muscles that control urination.

Operations to treat urge incontinence include enlarging the bladder or implanting a device that stimulates the nerve that controls the detrusor muscles.

Read more about non-surgical treatments for urinary incontinence and surgery and procedures for urinary incontinence

Causes Of Stress Urinary Incontinence

Stress urinary incontinence occurs when the muscles and other tissues that support the urethra and the muscles that control the release of urine weaken.

The bladder expands as it fills with urine. Normally, valve-like muscles in the urethra the short tube that carries urine out of your body stay closed as the bladder expands, preventing urine leakage until you reach a bathroom. But when those muscles weaken, anything that exerts force on the abdominal and pelvic muscles sneezing, bending over, lifting or laughing, for instance will put pressure on your bladder and can overcome the valve-like muscles or urinary sphincter causing urine leakage.

Your pelvic floor muscles and urinary sphincter may lose strength because of:

  • Childbirth: In women, tissue or nerve damage during delivery of a child can weaken the pelvic floor muscles or the sphincter. SUI from this damage may begin soon after delivery or occur years later.

Other factors that may worsen stress urinary incontinence include:

High-impact activities, such as running and jumping, over many years
Illnesses that cause chronic coughing
Obesity

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What Are Other Symptoms Of Urinary Incontinence

Besides the already-mentioned hallmark symptoms of each type of incontinence, the National Institute of Diabetes and Digestive and Kidney Diseases says that other symptoms might include:

  • Leaking urine without any warning or urge
  • Wetting your bed while sleeping
  • Leaking urine while having sex

Another symptom of urinary incontinence is urinating oftenmore than seven times per day or more than once at nightsays Dr. Sheyn.

Causes Of Urge Incontinence

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The urgent and frequent need to pass urine can be caused by a problem with the detrusor muscles in the walls of your bladder.

The detrusor muscles relax to allow the bladder to fill with urine, then contract when you go to the toilet to let the urine out.

Sometimes the detrusor muscles contract too often, creating an urgent need to go to the toilet. This is known as having an overactive bladder.

The reason your detrusor muscles contract too often may not be clear, but possible causes include:

  • drinking too much alcohol or caffeine
  • not drinking enough fluids this can cause strong, concentrated urine to collect in your bladder, which can irritate the bladder and cause symptoms of overactivity

Overflow incontinence may also be caused by your detrusor muscles not fully contracting, which means your bladder does not completely empty when you urinate. As a result, the bladder becomes stretched.

Your detrusor muscles may not fully contract if:

  • there’s damage to your nerves for example, as a result of surgery to part of your bowel or a spinal cord injury
  • you’re taking certain medicines

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What Are Stress Incontinence Symptoms

Leaking urine when theres pressure on your bladder is the top sign of stress incontinence. Mild stress incontinence may cause you to leak drops of urine during activities like heavy exercise, laughing, coughing or sneezing.

With moderate to severe stress incontinence, you may leak more than a tablespoon of urine even during less strenuous activities like standing up or bending over. You may even leak urine while having sex.

When To Seek Medical Advice

See a GP if you have any type of urinary incontinence. Urinary incontinence is a common problem and you should not feel embarrassed talking to them about your symptoms.

This can also be the first step towards finding a way to effectively manage the problem.

The GP may also suggest you keep a diary in which you note how much fluid you drink and how often you have to urinate.

Find out about diagnosing urinary incontinence.

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Causes Of Urinary Incontinence

Stress incontinence is usually the result of the weakening of or damage to the muscles used to prevent urination, such as the pelvic floor muscles and the urethral sphincter.

Urge incontinence is usually the result of overactivity of the detrusor muscles, which control the bladder.

Overflow incontinence is often caused by an obstruction or blockage in your bladder, which prevents it from emptying fully.

Total incontinence may be caused by a problem with the bladder from birth, a spinal injury, or a small, tunnel like hole that can form between the bladder and a nearby area .

Certain things can increase the chances of urinary incontinence, including:

  • pregnancy and vaginal birth

Find out more about the causes of urinary incontinence.

Treatment Options For Stress Incontinence

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Often, women with stress incontinence issues are referred to pelvic floor physical therapists who specialize in women’s health. The therapist will coach on how to conduct Kegel exercises to strengthen pelvic floor muscles to work more effectively and efficiently. If this doesn’t improve symptoms after adequate trial, other treatment options are considered.

There also is increased awareness and availability of in-home pelvic floor muscle training devices that are meant to help people perform better pelvic floor training. They’re usually in the form of an application-based biofeedback device that is inserted vaginally to gauge strength of the pelvic floor muscle contraction. Others provide electrical muscle stimulation to result in passive muscle contraction. Some devices are in the form of vaginal weights with various shapes and sizes. Data to support these muscle-training devices is limited yet promising for women with mild or moderate stress incontinence.

These devices should be removed at the end of each day and before intercourse. Studies are limited, yet show comparable effectiveness with no adverse effects.

The procedure carries an 85% to 95% success rate, with mesh complications reported at less than 3% if cases. The sling procedure is considered minor surgery. Patients often are discharged home the same day with minor limitations. This is the single most investigated procedure with strong cure rates, making it the gold standard of care.

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When Should You See A Doctor For Leaking Urine

Incontinence is common but not normal, says Sapienza. “I think suffer in silence thinking that they can’t get help, but it is treatable,” she says.

Some patients aren’t concerned with a few leaks here or there, and if it’s truly not bothering you, then you likely don’t need to see anyone, says Dr. Sheyn.

However, if you’re altering your life in order to manage symptoms, then talk to a doctor. For instance, maybe when you go to a new place, you immediately scout out a bathroom to make sure you know where to dash off to if the time comes. Or maybe you decline invitations out because you can’t be sure of the bathroom situation. Maybe you live in black leggings to hide urine leaks, something that patients often tell Sapienza they do.

You should also talk to your doctor if you’re leaking urine frequently. Besides the impact it can have on your social, work, and personal relationships, regular urinary incontinence can also lead to physical complications like skin problemsrashes, skin infections, and sores can develop from constantly wet skinand urinary tract infections. There’s this too: Chronic incontinence might be a sign of a more serious underlying condition, and that’s something you’d want to get checked out.

When To Seek Medical Help

Any instance of incontinence is reason to seek medical help. It may be a symptom of a more serious condition that needs to be treated.

Even if the underlying cause isnt serious, incontinence can be a major disruption in your life. Its important to get an accurate diagnosis and discuss treatment options with a healthcare professional.

In some cases, incontinence can be a sign of a medical emergency.

You should seek immediate medical attention if you lose control of your bladder and experience any of the following symptoms:

  • trouble speaking or walking

Urinary incontinence and treatment for urinary incontinence may result in complications, depending on the cause.

These complications may include:

  • Urinary tract infections. UTIs can be caused by wet undergarments against the skin. This may create an environment where bacteria can grow.
  • Kidney damage. In some cases where the flow of urine is obstructed, you may experience kidney trouble or kidney failure.
  • Cellulitis. This skin infection is caused by bacteria and may cause swelling and pain.
  • Medication side effects. Medications used to control urinary incontinence may cause side effects, depending on the medication. Side effects may include dry mouth, nausea, hypertension, or others.
  • Catheter side effects. If you have a catheter placed, you may experience side effects such as infection and trauma.
  • Mental health side effects. Urinary incontinence may cause feelings of anxiety, depression, or social isolation.

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Treatment For Stress Urinary Incontinence

It is important to have your symptoms assessed by a health professional who will assess your bladder behaviour and pelvic floor and confirm that you have stress urinary incontinence.

The main treatment for stress incontinence is pelvic floor exercises. Surgery to tighten or support the bladder outlet can also help. Medication may be used in addition to exercises if you do not want, or are not suitable for surgery.

There is medication available for treating women with moderate to severe stress urinary incontinence, along with pelvic floor muscle exercises. Older people with other problems in addition to their bladder may benefit from seeing a specialist in medicine for older people.

Solutions For Stress Urinary Incontinence

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Ask your healthcare provider to tell you about all the available solutions to help manage your stress urinary incontinence symptoms. Your provider should explain the benefits and risks of each treatment option to help you decide what will work best for you. Remember that not every solution works for everyone, and you may have to try more than one to find relief. Currently there are no drugs approved in the U.S. for treatment of stress urinary incontinence.

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What Causes Poor Bladder Control

Pelvic floor muscles help to hold urine in the bladder. Urine may leak out when you laugh, cough or sneeze if your pelvic floor muscles are weak. Pelvic floor muscles can be weakened by pregnancy and childbirth. You can also leak when you are active. Urine might leak when you exercise, get out of bed or stand up. If these muscles are weak already, getting older or being overweight can make them even weaker. Constipation can mean you need to strain to empty your bowels. This straining can also weaken your pelvic floor muscles.

Some people have a bladder muscle that does not contract well. The bladder may not empty out fully. These people have trouble passing urine normally.

Changestotheurethra

Any pressure on the urethra can cause it to narrow. This makes it difficult to get urine out of the bladder. This can happen in men due to an enlarged prostate. A prolapse of the uterus can affect how the bladder empties in women.

Fast Facts On Urinary Incontinence

  • Urinary incontinence is more common in females than in males.
  • There are a number of reasons why urinary incontinence can occur.
  • Obesity and smoking are both risk factors for urinary incontinence.

Urinary incontinence is when a person cannot prevent urine from leaking out.

It can be due to stress factors, such as coughing, it can happen during and after pregnancy, and it is more common with conditions such as obesity.

The chances of it happening increase with age.

Bladder control and pelvic floor, or Kegel, exercises can help prevent or reduce it.

Treatment will depend on several factors, such as the type of incontinence, the patients age, general health, and their mental state.

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What Lifestyle Changes Can Help Manage Stress Urinary Incontinence

Pelvic Floor Muscle Exercises

Kegels exercises can help strengthen your pelvic floor muscles. These are the muscles that help you control your bladder. You perform Kegels by contracting and relaxing the pelvic floor muscles several times each day. Exercising these muscles can make them stronger and help reduce or eliminate your stress urinary incontinence symptoms. To get the most benefit, you should do these exercises several times a day, every day.

To make sure you perform these exercises correctly, your healthcare provider may refer you to a physical therapist. This therapist is someone who specializes in pelvic floor muscle training and strengthening.

Maintain Good Bowel Function

Constipation can make stress urinary incontinence worse. Try to avoid constipation by eating high fiber foods such as fruits, beans and dark-colored vegetables to encourage regular bowel movements. It helps to drink 6 to 8 glasses of water each day, and exercise daily.

Maintaining a Healthy Weight

Being overweight or obese can increase the risk of developing stress urinary incontinence and losing weight reduces the severity of SUI symptoms. Many people find that losing just 10 pounds can lead to fewer leaks. Your healthcare provider can help you set safe, realistic goals for weight loss and behavior modification for a healthier lifestyle.

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It Could Be A Sign Of An Underlying Condition

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Naturally, later in life, people can experience incontinence because of increased production of urine related to aging kidneys. Bladder function is also heavily impacted by changing bladder capacity and chronic medical conditions like diabetes, says Fairchild. Chronic straining, coughing and/or constipation can all put stress on the bladder, she explains.

But leakage can also be sign of a more serious, underlying health condition, according to a 2018 National Poll on Healthy Aging.” For example, poor heart function could be the culprit behind frequent urination while sleeping.

If fluid is pooling in your legs during the day, when you lay down, that fluid redistributes and increases urine production, says Fairchild.

Although bladder leakage is common, discuss your particular symptoms with your doctor.

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