If you’re one of the 33 million Americans who struggle with overactive bladder (OAB) and bladder control, then you’ve probably considered asking your doctor about incontinence treatment. Nearly half of women over 50 have reportedly experienced bladder leakage, and it’s not uncommon for younger women to experience stress incontinence.
Even so, you might feel embarrassed or hesitant about approaching your doctor, so we’ve compiled this guide to help you feel more informed and confident when discussing treatment options with your physician.
What’s the Difference Between Overactive Bladder and Incontinence?
An overactive bladder (OAB or urge incontinence) means you’ve got to go –frequently,and there’s typically urgency involved. You may or may not leak urine, but your bladder signals you to find a bathroom so often you begin to recognize it as a problem. The average person urinates about 6 or 7 times daily, but some may go 4 to 10 times in a day and still be healthy.
So how do you know if you’re going too much? If frequent urination interferes with your quality of life, then you might have OAB.
Urinary incontinence is simply loss of bladder control. Frequency and urgency often accompany incontinence – but not always. It could be as simple as leaking small amounts of urine when you laugh or cough or as serious as not making it to the bathroom in time. Either way, the condition leaves many people feeling uncomfortable and embarrassed. Often, some simple lifestyle changes improve or alleviate symptoms, but for those who continue to struggle, it’s worthwhile to talk to your doctor about the other incontinence treatments outlined below.
Causes of OAB
Overactive bladder typically means that the urinary bladder contracts even when it doesn’t need to (i.e. your bladder isn’t full). If you’re not over-hydrating with excessive liquid or drinking large amounts of caffeine or alcohol, then it’s worth talking to your doctor if your symptoms become uncomfortable.
Other medical conditions that cause frequent urination:
- Urinary Tract Infection (UTI)
- Pelvic floor weakness
- Interstitial Cystitis (bladder inflammation)
- Prostate problems
- Hypocalcemia or hypercalcemia (high or low calcium levels)
- Sickle Cell Anemia
Causes of Urinary Incontinence
Age is the most common cause of persistent urinary incontinence. As you get older, so does your bladder muscle, which means you can’t hold urine like you did before. You might also experience more frequent involuntary bladder contractions that tell you to find a bathroom immediately and more often.
- Enlarged prostate
- Prostate cancer
- Urinary tract obstructions (tumors, stones)
- Neurological disorders (MS, Parkinson’s, stroke, brain tumor, spinal injury)
Lifestyle Changes for Incontinence Treatment
Many people find that some adjustments to their daily life brings relief from OAB or incontinence. If you missed our recent article 8 Ways to Keep Your Bladder Healthy for the New Year, pleaserefer to it for some easy lifestyle changes that could improve milder symptoms.
Meanwhile, let’s look at some other natural ways to approach incontinence treatment.
Find Your Zen with Yoga
Before you think, “I could never do that!” just hear me out. Remember that there are many levels of yoga. Free apps like Down Dog offer “restorative” yoga options that include mostly floor stretches. You get the advantage of coaching, thorough instructions, and deep breathing along with the total body benefit of deep stretching. For those who find they want a greater challenge, it’s easy to increase your level through beginner, intermediate, and advanced to try more challenging poses.
How does yoga help incontinence? Yoga serves an incontinence treatment in two effective ways.
First, it builds core strength gently and helps tighten the muscles that control the urethral sphincter. In other words, you’ll be able to hold your urine for longer periods of time without any leakage. It’s similar to the benefit of Kegel exercises.
Second, yoga reduces stress and general anxiety levels which also improves incontinence symptoms. No kidding! Stress puts your body in fight or flight mode, stimulating adrenaline. As adrenaline floods your body, it causes the urgent need to urinate. Regardless of the source of your stress, it can have a notable impact on your bladder function. Yoga helps manage anxiety levels, keeping your adrenaline (and incontinence) in check.
Train Your Bladder
The idea of bladder training as an incontinence treatment might seem strange at first, but it’s really nothing more than urinating on a schedule. Use this method if your doctor has cleared you of any underlying medical conditions and stress incontinence (too much pressure on the bladder).
Sometimes we unknowingly “train” our bladders the wrong way by urinating before our bladder is full. Over time, our bladders will signal to us that its time find a bathroom long before we have a full bladder.
Bladder training is about reversing this bad habit by gradually increasing the time between urination by 15 minutes until you reach a comfortable level. You’ll want to aim for 3 hours between bathroom trips, but if you’re very well hydrated (like a diabetic who drinks a lot of fluids) and don’t mind the additional potty breaks, then two hours is acceptable.
Visit Harvard’s health blog for step-by-step instruction on bladder training.
Get More Vitamin D
When it comes to a healthy bladder, a strong pelvic floor is key. In addition to Kegels and yoga, ask your doctor to check your vitamin D levels. A deficiency in this important vitamin might lead to weaker pelvic floor muscles. Researchers found that higher vitamin D levels in women of all ages notably decreased the risk of developing pelvic floor disorders that contribute to incontinence.
As an incontinence treatment, your doctor may recommend a vitamin D supplement, but it’s also important to add vitamin D to your diet by eating salmon, canned tuna, eggs, and fortified dairy. If you’re on a vegan or plant-based diet, the National Institutes of
Health says you can achieve similar results with a little sunshine:
…approximately 5–30 minutes of sun exposure between 10 AM and 3 PM at least twice a week to the face, arms, legs, or back without sunscreen usually lead to sufficient vitamin D synthesis and that the moderate use of commercial tanning beds that emit 2%–6% UVB radiation is also effective.
If you’re prone to skin cancer, speak to your dermatologist about how much sun exposure is safe for you, or rely on diet and supplements to get the nutrients you need.
The key is moderation, so spend under 30-minute in the sun twice a week, and if you want to enjoy the great outdoors longer, slather on some sunscreen or cover up. If you’re at work during prime sunbathing time, try a short walk at lunch time on sunny days.
Common Medications for Incontinence Treatment
Lifestyle changes and supplements don’t work for everyone. If you’ve cut out the caffeine, are faithful to kegels and yoga, and have even tried bladder training to no avail, you might think you’re out of options. But there are several medications that have proven successful for OAB and some types of incontinence, so talk to your doctor about them. Of course, every medicine has side effects, and together, you and your doctor can weigh the pros and cons of using prescription for your symptoms.
These drugs block the chemical messenger that tells your brain to begin abnormal bladder contractions. When bladder training isn’t helpful, anticholinergics directly intervene to stop the unnecessary urges to urinate.
Anticholinergic medications include:
- Oxybutynin (Ditropan XL, Oxytrol)
- Tolterodine (Detrol)
- Darifenacin (Enablex)
- Solifenacin (Vesicare)
- Fesoterodine (Toviaz)
Be aware that it could take several weeks for symptoms to improve when taking these medications, and it might be up to 12 weeks before you feel the full effects.
You might have seen a commercial for this one recently. It relaxes the bladder muscle, thereby increasing the volume of urine your bladder can hold. It also aids in more complete emptying when you go.
Common side effects include nausea, diarrhea, constipation, dizziness, and headaches. It might also increase blood pressure. Talk to your doctor about possible drug interactions.
Onabotulinumtoxin Type A (Botox)
You probably did a double take on this one. Yes, it’s exactly what you think. Medical professionals inject Botox into your bladder muscle to block chemical messengers that stimulate bladder contraction. Your doctor may recommend injections once or twice a year if other medications, including anticholinergics, haven’t worked for you.
Few side effects are associated with Botox injections for incontinence treatment.
Doctors most often prescribe this for women who experience incontinence or OAB after menopause when estrogen levels drop. The drop in estrogen levels may aid in the deterioration of tissue surrounding the bladder. When the bladder doesn’t receive proper support, it often triggers stress incontinence – or too much pressure on the bladder.
Estrogen for incontinence treatment is often prescribed as a low-dose topical estrogen. It’s typically a vaginal cream or an estrogen patch that, when applied, aims to revitalize the deteriorating tissues affecting your bladder control and urgency.
If you use estrogen for incontinence as directed, you’re not likely to experience any side effects.
This medication isn’t recommended for older adults, because it’s a tricyclic antidepressant. When used as a urinary incontinence treatment, it allows the bladder muscle to relax while also contracting the muscles in the bladder neck. This means you can hold more urine longer without leaking. It’s typically used for a combination of urge and stress incontinence.
Imipramine is known to cause drowsiness and is best taken at night. Other rare but serious side effects should be considered.
Doctors typically prescribe this mediation for men with overflow incontinence (leaking urine from a full bladder without the urge to urinate). It relaxes bladder neck muscles as well as muscle fibers in the prostate. This aids in bladder emptying and prevents overflow incontinence.
Common alpha blockers include:
- Tamsulosin (Flomax)
- Alfuzosin (Uroxatral)
- Silodosin (Rapaflo)
- Doxazosin (Cardura)
Most Common Devices for Incontinence Treatment in Women
When medications aren’t effective or desirable due to side effects or interaction with other medication, your next step might be a device to relieve your symptoms. You might cringe at the assumed discomfort, but for many women it’s a very viable option that brings relief.
This very small device inserts into the urethra tube before specific physical activities that trigger incontinence. It acts as a tiny plug to prevent leaks but is made to remove before urination. It helps you avoid surgery while maintaining an active lifestyle without bladder leakage. Urinary Tract Infection (UTI) is the most common side effect of a urethral insert.
It’s a rigid ring that comes in many shapes and sizes. You insert into your vagina and wear it all day to support your bladder and prevent urine leaks without surgical intervention. It’s most useful for women who want a non-surgical option for prolapsed bladder.
Surgical Procedures to Treat Incontinence
Surgery is typically the last resort or used in the most difficult cases. Surgical procedures treat the cause of your incontinence more directly and offer a permanent solution. As with all surgery, there’s always risk involved. Be sure to thoroughly discuss the pros and cons of surgery with your doctor and remember to consider how it will improve your quality of life.
A sling helps to keep the urethra closed during sudden movements like coughing or sneezing. It’s most often used to treat stress incontinence. A surgeon will use either strips of tissue from your own body or a synthetic mesh to create a pelvic floor sling around your urethra and bladder neck. This surgical incontinence treatment eases pressure on your bladder and prevents leaking.
Bladder Neck Suspension
This surgery targets the same problem as the bladder sling, which is to support your drooping urethra and bladder neck. Instead of a sling, a surgeon places sutures in vaginal tissue near your bladder neck and then attaches the sutures to ligaments near your pubic bone. Your doctor will know which surgical option will work best for your type of stress incontinence.
If your doctor suggests prolapse surgery, it means that more than one pelvic organ (vagina, uterus, bladder, urethra, and rectum) has dropped low enough to warrant using a combination of sling procedures and reconstructive prolapse surgery. The goal is to provide support for prolapsed organs using slings and other surgical means, which restores them to their original positions. Successful surgeries often reverse stress incontinence symptoms.
Incontinence Solutions that Work for You
The Tye Medical team is here to support you as you consider which incontinence treatment might work for you. In the meantime, consider our premium line of absorbent products ranging from light leaks to overnight protection.
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