Bladder Control Problems in Women
INTRODUCTION
Bladder control problems are very common - approximately 126,000 women in New Zealand experience urine leakage twice or more per month.
40,000 women experience some degree of urinary incontinence on a daily basis. Urinary incontinence is more common in women than men, with a ratio of 4:1.
2/3 of women who suffer from bladder control problems do not ask for help, as they see this as a normal female problem and think nothing can be done.
70% of women with bladder control problems can become dry again or experience significant improvement.
Ask a health professional for help. You should consult your GP first. You may be referred to a Continence Adviser (a nurse or physiotherapist with special expertise in continence management), Urologist, Gynaecologist or Geriatrician.
NORMAL BLADDER CONTROL
The production of urine is not at anytime under our control, but as adults we have acquired the ability to recognise when our bladder is full, and to be able to hold on to urine until we reach a toilet. We therefore have control over when and where we will ass urine. This control is possible because of messages passing between the brain and the bladder, and our ability to interpret these messages. When we have this control we are said to be continent
.
INCONTINENCE
Incontinence is a symptom that one of the mechanisms which keeps us dry is not working correctly. How incontinence presents itself, varies according to what is causing it. For this reason it is important to seek professional help from your GP, physiotherapist or continence adviser, so that the cause can be found and appropriate treatment given.
TYPES OF INCONTINENCE
The two types of incontinence most common in women are:
Stress Incontinence
: This is the involuntary loss of urine when pressure inside the abdomen is increased by activities such as sneezing, laughing, running or lifting. It is not associated with the desire to pass urine.Urge Incontinence
: Urgency is a sudden, strong urge to pass urine. If a person is unable to get to the toilet in time, and experiences an involuntary loss of urine they are said to have "urge incontinence."NB: Many women suffer from a combination of urge and stress incontinence.
Some factors that contribute to bladder control problems;
1. Pregnancy and childbirth
2. Constipation
3. Drugs
4. Chronic cough
5. Urinary infection
6. Diseases which affect the nervous system and muscular control
7. Diabetes
8. Obesity
9. Reduction in hormones after menopause (change of life).
FOR GOOD BLADDER CONTROL
Boss your bladder
: Do not allow yourself to become controlled by your bladder; you should be controlling it. Adults can usually go 3-4 hours between passing urine during the daytime, and should not get up more than once during the night.Fluids
: Drink an adequate amount of fluid. Assuming there are no other medical problems 6-8 glasses (1000-1500 mls) per day is the amount to aim for. This amount ensures that urine does not become concentrated and that there is enough available fluid to keep bowel motions moist and soft, therefore avoiding constipation. It is advisable to reduce your intake of bladder irritants such as tea, coffee, cola drinks and alcohol.Diet
: Pay attention to your diet. Make sure it contains fibre roughage every day, in the form of wholemeal bread, wholegrain cereals, fruit and vegetables. Fibre adds bulk and attracts fluid to the waste matter in the bowel motion.Bowels/laxatives
: Avoid straining while opening your bowels as this can stretch the muscles of the pelvic floor and may eventually result in weakness occurring. Do not take laxatives unless advised by your doctor. The bowel becomes reliant on laxatives if they are taken over a long period of time and eventually will not function without them.Medications
: Many medications prescribed for other rnedical conditions can affect bladder control. Check with your doctor.Weight
: Avoid becoming overweight, as this puts extra pressure on the pelvic floor muscles.Pelvic Floor Muscles
: The pelvic floor muscles support all the organs in the abdomen, especially when standing upright. The pelvic floor muscles should be tightened whenever lifting, bending, coughing,laughing, sneezing etc-. All women, men and children should be taught how to do these exercises.
For instruction in the correct method of doing these exercises, see brochure entitled 'Pelvic Floor Muscle Exercises'. If not satisfied with your progress in doing these exercises, you should consult your GP or a physiotherapist (with an interest in continence).
Pelvic Floor Muscle Exercises
WHAT TO DO ABOUT YOUR INCONTINENCE
The good news is that seven out of ten women with stress incontinence can become dry, or significantly improved doing pelvic floor exercises. Only a small number of women may require surgery.
Most urge incontinence can be corrected by bladder retraining which is sometimes combined with medication.
DO YOU HAVE ANY QUESTIONS?
Ask a health professional for help. You should consult with your GP first.
You may be referred on to a Continence Adviser, Urologist or Geriatrician.