Your Health: Bladder Control Problems Are Treatable

Rallie McAllister, M.D., M.P.H.
A few things haven't changed since kindergarten, like the rules and regulations regarding potty breaks. If you've ever lost control of your bladder as an adult, you may have felt just as embarrassed as you did when you were a preschooler. Although it may be unsettling, involuntary loss of urine isn't uncommon. Urinary incontinence, the official name for involuntary leakage of urine from the bladder, currently affects more than 12 million American adults. Urinary incontinence is more prevalent in older individuals, but young people aren't immune to the condition. Women are more likely to be affected than men for several reasons. Childbirth can weaken or injure the nerves and muscles of the pelvis, especially in women who deliver big babies or those who require forceps deliveries. Nearly a third of U.S. women experience long-term bladder leakage following childbirth. Among men, those with enlarged prostate glands are at increased risk for bladder control problems. Temporary urinary incontinence is relatively common following surgical procedures involving the bladder or prostate, and in some cases, the condition may be permanent. The involuntary loss of urine from the bladder may be due to one of several types of urinary incontinence -- each with different causes, symptoms and treatments. Stress incontinence is a condition in which involuntary loss of urine occurs during activities involving the muscles of the abdomen and pelvis, including sneezing, laughing or coughing. Stress incontinence may occur during running, jumping and other types of exercise, since these activities create physical forces that push down on the bladder and force urine out of the body. Urge incontinence, also known as overactive bladder, is caused by urinary muscle spasms that lead to the uncontrolled loss of urine. In many cases, individuals who suffer from an overactive bladder experience strong, unexpected urges to void, especially after drinking liquids or hearing the sound of running water. Overflow incontinence occurs when the bladder stays perpetually full. As additional urine is manufactured by the kidneys and delivered to the bladder, the excess liquid dribbles from the body. If you experience problems with bladder control, you may be a little embarrassed, but you shouldn't let it prevent you from seeking medical attention. In some cases, urinary incontinence is completely reversible, especially if the condition is the result of a medication side effect or caused by a smoldering urinary tract infection. Even if the condition isn't easily reversible, you're not doomed to a lifetime of dampness. Fortunately, a number of effective treatment options are available. Surgery can return a dropped bladder to its proper position, enlarge a small bladder or tighten weakened pelvic muscles. In many cases, a more conservative approach to treatment can correct the cause of urinary incontinence and put a stop to bladder-control problems. A cure might be as simple as treating an infection with antibiotics or taking a daily dose of medication that prevents problematic bladder contractions. If the condition doesn't respond to drug therapy, specific exercises may be helpful. Your doctor may instruct you to begin urinating at frequent, regular intervals, starting with once every hour and then progressively lengthening the interval. This practice, known as bladder training, significantly reduces symptoms in three-quarters of affected individuals and completely eliminates the problem in nearly 15 percent of those with urinary incontinence. If you have mild symptoms of urinary incontinence, you may be able to improve bladder control with pelvic floor exercises. Also known as Kegels, these exercises have been shown to improve bladder control in about 80 percent of incontinent adults. Kegels are easy to perform, and you can do them anywhere without anyone being the wiser. To execute the perfect Kegel, simply contract the muscles you would use to stop the flow of urination. It may require a little experimentation, but once you've mastered the maneuver, simply hold the contraction for three seconds and then relax for three seconds. Repeat this exercise 10 to 15 times per session, and try to squeeze in three sessions per day. Kegel exercises can be very effective, but only when they're done regularly. The more you exercise your pelvic floor muscles, the more likely you are to see significant improvements in bladder control. In addition to performing Kegels, losing excess weight can significantly improve symptoms of urinary incontinence. Avoiding alcohol and caffeine may also be helpful. If exercises and dietary changes don't seem to help, it's time to see your doctor. With proper treatment, there's an excellent chance you can overcome urinary incontinence for good.

Rallie McAllister is a board-certified family physician, speaker and the author of several books, including "Healthy Lunchbox: The Working Mom's Guide to Keeping You and Your Kids Trim." Her Website is http://www.rallieonhealth.com/. To find out more about Rallie McAllister, M.D., and read features by other Creators Syndicate writers and cartoonists, visit the Creators Syndicate Web page at http://www.creators.com/.
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