Annoying. Embarrassing. And most of all, worrying.
University of Minnesota Health Urologist Cynthia Fok, MD, MPH, often hears these words when seeing female patients with complaints about incontinence or leaky bladder.
For many, the only thing worse than their concerns about public embarrassment is the underlying fear that their condition is a symptom of a terrible illness—or that it’s simply an unavoidable part of aging.
Fortunately, neither is necessarily true, said Fok, a reconstructive surgeon and specialist in female pelvic medicine. Millions of American women are sometimes incontinent. While the problem can be caused by a tumor near the urinary tract or an underlying neurological disease, it is more commonly the result of simple issues such as urinary tract infections, constipation or pelvic floor dysfunction. Many of those, in turn, may be related to changes from childbirth, menopause, or pelvic surgeries such as a hysterectomy.
Treatments varies depending on what causes the problem, Fok said. Urge incontinence, or an overactive bladder, is a leak associated with frequency, and the urgent need to use the bathroom. Stress incontinence is a leak that occurs because of increased abdominal pressure caused by sneezing, coughing or other factors.
Kegel exercises, which involve flexing the muscles used to stop the flow of urine, can be helpful in stress incontinence. For urge incontinence, many women can learn to re-train their bladder by tracking when they need to urinate and gradually decreasing the frequency of their bathroom visits.
“Some women complain that they’ve tried Kegel exercises without success, but we find that many patients have been doing them wrong, or haven’t done them regularly enough to experience the real benefits,” Fok said. “We often recommend working with a physical therapist to help treat any type of urinary incontinence, for the same reason that it’s easier to develop six-pack abdominals if you’re working with a professional trainer.”
In some cases, Fok said, dietary changes can also help. Some drinks, foods and medications can stimulate the bladder and increase urine flow. She sometimes urges patients to cut back on or stop drinking carbonated drinks, alcohol or coffee (even the decaffeinated kind). She also may suggest avoiding foods with a lot of sugar, acid or spice. Some heart and blood pressure medications, along with muscle relaxants and sedatives, also can contribute to overactive bladder.
Other minimally invasive treatment options are available for both stress and urge incontinence including medications, weight loss and surgery.
“The most important thing is to see a physician about the problem,” Fok said. “Some women just don’t want to talk about it, but there are a number of simple treatment options available. You don’t need to ‘just live’ with this.”