Posts Tagged ‘leaking urine’

Urinary Incontinence: Gotta Go, Gotta Go Right Now!

November 28, 2015

Urinary incontinence affects millions of Americans and causes havoc with their lives.  It I a source of embarrassment, shame and often depression.  Other medical consequences of incontinence include skin irritation, urinary tract infections, and pelvic pain.  This blog will discuss treatment options including medications and non-medical solutions.

Urinary incontinence means that the person suffering from it starts losing his/her control over the bladder. This leads to several kinds of problems of the urinary system including sudden urination, slow but steady leakage of urine, or dripping of urine when one undertakes a physically stressful exercise like lifting weight.  Those who have incontinence often lose urine with coughing, laughing, or sneezing.

Although this is a common medical problem, many suffers continue to suffer in silence, living a secluded and reclusive life.

While these causes cannot be controlled, it is important to take note of and control factors that can worsen the condition:

Medication

If you have a problem of urinary incontinence and the symptoms have gone from bad to worse, you need to check with your doctor about the medication or drugs you have been taking. For, chances are that some of these may be exacerbating the problem. Certain drugs to treat high blood pressure are linked to an increase in incontinence.

Alpha blockers dilate blood vessels to reduce blood pressure and they also often relax the muscles of the bladder, furthering urine flow. Some drugs to treat depression can contribute to worsening incontinence symptoms.

Anti-depressants work by relaxing the nerves of the mind and may also affect the ability of the bladder muscles to contract (side effects).

Diuretics are another set of drugs that are associated with increased

urination. In fact, these drugs are also called ‘water pills’, and are designed to flush out excess salt from your body to treat conditions like high blood pressure.

Caffeine

Caffeine is an important component of our daily lives as most of us consume it through coffee, tea and chocolates. Excessive consumption of caffeine is associated with the problem of increased urination. While mild consumption doesn’t have a negative effect, excess consumption can affect the renal system, as caffeine is a stimulant. It stimulates the cardiovascular system, increasing the heart rate as well as blood pressure. This increases the rate of blood to be filtered. It also relaxes the bladder’s detrusor muscles, causing them to feel fuller more frequently. So, limiting caffeine intake is healthy.

Type 2 diabetes

Type 2 diabetes is a major health concern of today as it affects the functioning of the entire body. It also increases the risk of urinary incontinence, as well as its severity. Efforts should be made to prevent and control diabetes by keeping your weight under control, exercising regularly and leading a healthy lifestyle.

Excessive weight also puts extra pressure on the pelvic muscles and weakens them. Therefore, it is also important to control body weight.

Solutions

Besides controlling the aforementioned factors, it is important to take medical help to treat and manage urinary incontinence.

In some patients, adopting behavioral changes may help. For example, decreasing fluid intake to average levels, urinating more frequently to decrease the amount of urine that is held in the bladder and keeping regular bowel habits (as constipation can worsen the problem) may have a positive effect.

Pelvic muscle training exercises, aka Kegel exercises, can specifically help those who suffer from incontinence. The exercises help patients exercise better control of their detrusor muscles.

Weight loss has also been shown to help decrease symptoms in overweight people.

Bottom Line:  Urinary incontinence is a common condition affecting millions of American men and women.  Help is available and no one needs to “depend on Depends”!

Wearing Diapers? Check Your Medications Which May Be The Culprit

December 20, 2012

Urinary incontinence affects millions of American men and women.  There are dozens of medications that can be contributing to the cause of incontinence.  Often times stopping these medications, with physician’s approval, or changing to another drug, also with physician approval, may help control the urine process. 

There are many types of urinary incontinence, the most prevalent being “urge incontinence” — an urge to urinate so sudden and strong that you often can’t get to a bathroom in time. When this type of incontinence has no identifiable cause, it’s called “overactive bladder.”

The drugs typically used to treat this condition include darifenacin (Enablex), fesoterodine (Toviaz); oxybutynin (Ditropan), solifenacin (Vesicare), tolterodine (Detrol) and trospium (Sanctura). These are all anticholinergics — drugs that block the effects of acetylcholine, a neurotransmitter associated with muscle activation, learning and memory.

Many commonly prescribed drugs can also cause incontinence or make it worse. Among them:

  • heart medications
  • blood-pressure medications      (amlodipine, furosemide, hydrochlorothiazide, lisinopril and furosemide,      for example)
  • antidepressants
  • muscle relaxants
  • diuretics
  • sleeping pills

I’d recommend that you work closely with your physician to determine; if at all possible, what might be causing her incontinence. Smoking or being overweight can be contributing factors, for example.

While it’s not always possible to pinpoint a cause, I find that adjusting a patient’s medications often resolves or, at least, substantially lessens the problem. Some simple behavioral techniques — including bladder training and scheduled toilet trips — can help, too.

Bottom Line:  Incontinence is a common problem.  Make sure your medications aren’t causing the problem or making it worse.  Check with your doctor.

 

A Kegel A Day Keeps the Doctor Away

April 22, 2010

Mary Ann is a 45-year old woman who loses urine (incontinence) when she coughs and sneezes.  She is provided with exercises to strengthen the pelvic floor muscles of her bladder. She does the exercises every day for 12 weeks and has significant improvement in her urinary symptoms.

There are many conditions that put stress on your pelvic floor muscles such as childbirth through vaginal deliveries, obesity, chronic coughing, and after menopause when there is a deficiency of estrogen or the female hormone produced in the ovaries.

When your pelvic floor muscles weaken, your pelvic organs descend and bulge into your vagina, a condition known as pelvic organ prolapse. The effects of pelvic organ prolapse range from uncomfortable pelvic pressure to leakage of urine or feces. Fortunately, Kegel exercises can strengthen pelvic muscles and delay or maybe even prevent pelvic organ prolapse.

How to perform Kegel exercises

It takes diligence to identify your pelvic floor muscles and learn how to contract and relax them. You can learn to identify the proper pelvic muscles by trying to stop the flow of urine while you’re going to the bathroom.

If you’re having trouble finding the right muscles, don’t be embarrassed to ask for help. Your doctor can give you important feedback so that you learn to isolate and exercise the correct muscles.

After you’ve identified your pelvic floor muscles contract your pelvic floor muscles and hold the contraction for three seconds then relax for three seconds.  Repeat this exercise 10 times.  After you have learned how to contract the pelvic muscles for 3 seconds, work up to keeping the muscles contracted for 10 seconds at a time, relaxing for 10 seconds between contractions.  Perform a set of 10 Kegel exercises three times a day. The exercises will get easier the more often you do them. You might make a practice of fitting in a set every time you do a routine task, such as sitting at a red light.

For those women who have trouble doing Kegel exercises, biofeedback training or electrical stimulation may help. In a biofeedback session, a nurse, therapist or technician will either insert a small monitoring probe into your vagina or place adhesive electrodes on the skin outside your vagina or rectal area. When you contract your pelvic floor muscles, you’ll see a measurement on a monitor that lets you know whether you’ve successfully contracted the right muscles. You’ll also be able to see how long you hold the contraction.

Results are not immediate or the first time you do the exercises.  You can expect to see some results, such as less frequent urine leakage, within about eight to 12 weeks. Your improvement may be dramatic — or, at the very least, you may keep your problems from worsening. As with other forms of physical activity, you need to make Kegel exercises a lifelong practice to reap lifelong rewards.

An added bonus: Kegel exercises may be helpful for women who have persistent problems reaching orgasm.

Bottom Line:  Many women have a problem of loss of urine with coughing and sneezing.  Kegel exercises are effective for very mild urinary incontinence.  It’s inexpensive, does not require use of medication, and if you are patient, it does, indeed, work.

You Don’t Have to Depend on Depends-Menopause and Bladder Control-

March 10, 2010

Some women begin to have problems with their bladder and experience overactive bladder (gotta go, gotta go right now) and urinary incontinence or loss of urine at inopportune times at the time or shortly after menopause.

Does Menopause Affect Bladder Control?

Yes. Some women have bladder control problems after they stop having periods (menopause or change of life). If you are going through menopause, talk to your health care team.

After your periods end, your body stops making the female hormone estrogen. Estrogen may help keep the lining of the bladder and urethra healthy. A lack of estrogen could contribute to weakness of the bladder control muscles.

Pressure from coughing, sneezing or lifting can push urine through the weakened muscle. This kind of leakage is called stress incontinence.

Although there is no evidence that taking estrogen improves bladder control in women who have gone through menopause, small does may help thicken the bladder lining and decrease the incontinence.  Your doctor can suggest many other possible treatments to improve bladder control.

What Else Causes Bladder Control Problems in Older Women?Sometimes bladder control problems are caused by other medical conditions. These problems include:

Infections

Nerve damage from diabetes or stroke

Heart problems

Medicines

Feeling depressed

Difficulty walking or moving

A very common kind of bladder control problem for older women is urge incontinence. This means the bladder muscles squeeze at the wrong time and cause leaks.

If you have this problem, your doctor can prescribe medication that can certainly alleviate that problem.

What Treatments Can Help You Regain Bladder Control?Your doctor may recommend limiting foods or fluids, such as caffeine, which are bladder irritants and increase the desire to go the rest room.

There are also pelvic exercises that can strengthen the muscles in the urethra and the vagina.   Life’s events, like childbirth and being overweight, can weaken the pelvic muscles.

Pelvic floor muscles are just like other muscles. Exercise can make them stronger. Women with bladder control problems can regain control through pelvic muscle exercises, also called Kegel exercises.

Exercising your pelvic floor muscles for just five minutes, three times a day can make a big difference to your bladder control. Exercise strengthens muscles that hold the bladder and many other organs in place.

Two pelvic muscles do most of the work. The biggest one stretches like a hammock. The other is shaped like a triangle. Both muscles prevent leaking of urine and stool.

Pelvic exercises begin with contracting the two major muscles that stretch across your pelvic floor. There are three methods to check for the correct muscles.

1. Try to stop the flow of urine when you are sitting on the toilet. If you can do it, you are using the right muscles.

2. Imagine that you are trying to stop passing gas. Squeeze those same muscles you would use.

3. Lie down and put your index finger inside your vagina. Squeeze as if you were trying to stop urine from coming out. If you feel tightness on your finger, you are squeezing the right pelvic muscle.

Do your pelvic exercises at least three times a day. You can exercise while lying on the floor, sitting at a desk or standing in the kitchen.

Be patient. Don’t give up. It’s just five minutes, three times a day. You may not feel your bladder control improve until after three to six weeks. Still, most women do notice an improvement after a few weeks.

Other treatments include inserting a device, a pessary, directly into the vagina to lift the urethra and the base of the bladder to its proper position behind the pubic bone.  And finally, if the conservative methods of medication, exercises, and dietary modification don’t work, then you should talk to your doctor about one of the surgical procedures that can lift the bladder into the proper position to prevent leakage

Bottom Line: No one needs to suffer the embarrassment of urinary incontinence.

Dr. Neil Baum is a physician at Touro Infirmary and can be reached at (504) 891-8454 or through his website, http://www.neilbaum.com