What can be done about Incontinence?
- On May 28, 2015
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In many cases incontinence or bladder weakness can be cured or at least improved. The level of improvement depends on what has caused the incontinence in the first place. A toilet training programme, change in diet or regular exercise may be all you need in order to regain control and your confidence. We always recommend you see your Doctor or local continence advisor so that they can recommend the best course of action. There are also different kinds of medication they may consider to help minimize or manage your condition.
A combination of treatments may be needed. Your doctor is likely to suggest the least invasive treatments first and move on to other options only if these techniques fail.
Stress Incontinence can be managed and improved though a variety of steps, some simpler than others. It is likely that your health professional will recommend you to do pelvic floor muscle exercises (Kegel exercises). These exercises are designed to strengthen the pelvic floor muscles to help you control urinating.
Some women find that additional oestrogen improves the strength and elasticity of their muscles, so hormone replacement therapy may be a consideration.
In some cases, but only if other treatment has not worked, your doctor may refer you for a surgical assessment. This usually involves a procedure to raise your bladder into a better position and repair the effects of a weakened pelvic floor.
Urge Incontinence is often referred to as Overactive Bladder as the bladder contracts involuntarily. The best way to improve urge incontinence may be to retrain the bladder to delay urination after you get the urge to go. Over time, you can gradually stretch the bladder so that it can hold more urine. This means that you will have more time to get to the toilet after you feel the “urge” and you are less likely to leak urine. Your doctor, nurse, or continence advisor will explain how to do bladder retraining. You may start by trying to hold off for 10 minutes every time you feel an urge to urinate. The goal is to lengthen the time between trips to the toilet until you’re urinating only every two to four hours.
Also using mental tricks can take your mind off the urge. For example, distract yourself by thinking of as many words as you can beginning with the letter A, and then work your way through the alphabet.
Doing pelvic floor exercises can also help. They will not cure the bladder contractions that cause the urge, but stronger pelvic floor muscles will support your bladder and help minimize any leakages.
Often treatment depends on the diagnosis of the underlying cause of the Overflow Incontinence, e.g. if medication is causing the problem then the solution may simply be to stop the medication or change the drug used.
When the underlying cause is not known then bladder retraining or pelvic floor exercises may help improve the condition although will not resolve it.
Other treatments may include surgery (if the problem is found to be caused by a blockage such as a tumour or stone that can’t be passed) or medication such as alpha-blockers. These can be effective in reducing the symptoms of overflow incontinence by relaxing the portion of the urinary tract where the bladder flows into the urethra and thereby allowing urine to flow out more easily.
Your doctor may also recommend double voiding, to help you learn to empty your bladder more completely to avoid overflow incontinence. Double voiding means urinating, then waiting a few minutes and trying again.
What else can I do?
Treatments for anything which can cause increased pressure on the bladder, such as constipation, fibroids, etc. will help reduce the incidence of incontinence. Also weight loss may help if you’re very overweight. There are also a variety of drugs available. They can have some effect but may need to be continued for several months at least.
Eating plenty of fresh fruit, vegetables and fibre can help avoid constipation (this can cause pressure on the bladder and the urethra, which in turn my result in incontinence).
You can also ensure that you empty your bladder properly each time. Firstly sit up straight whilst you are passing urine with your feet on the floor. Empty your bladder then lean forward at the waist and lean from side to side to ensure that the bladder is completely empty, taking your time to do this.
Stopping smoking can reduce the likelihood of experiencing urge incontinence. Also smokers cough more frequently than non-smokers which can exacerbate the situation.
It is recommended to avoid diuretic drinks such as alcohol, and drinks which contain caffeine (i.e. coffee, cola, tea, etc.) as these cause your kidneys to produce more urine. However you should not cut down on the amount of water you drink (in fact you should drink 3 to 4 pints (2 litres) a day). Drinking less will only make your urine more concentrated, which will irritate the bladder, causing you to urinate more often and may make urinating more painful. However, it is not recommended that you drink excessive amounts either as this could lead to distension of the bladder.
Scheduled toilet trips, to urinate every two to four hours rather than waiting for the need to go, may also help.