Bladder control problems occur when someone has trouble holding or releasing urine. One of the most common bladder problems people experience is accidental loss in urine, also referred to as urinary incontinence. If you experience this issue daily, here are some ways that you can manage it easier.
Medication and bladder Control
If so, one cause of your problem may be sitting in your medicine cabinet. Medicines (drugs) can cause people to lose bladder control. Do not stop taking any medicine without talking to your doctor.
If your medicine is causing your bladder problem, your doctor may find another medicine. If you need to keep taking the same medicine, your doctor can help you find another way to gain bladder control.
How does bladder control work?
Your bladder is a muscle shaped like a balloon. While the bladder stores urine, the muscle relaxes. When you go to the bathroom, the bladder muscle tightens to squeeze urine out of the bladder. Two sphincter (SFINK-tur) muscles surround a tube called the urethra (yoo-REE-thrah). Urine leaves your bladder through this tube. The sphincter muscles relax during urination in order to allow urine to pass through the urethra.
The sphincters keep the urethra closed by squeezing like rubber bands. Pelvic floor muscles under the bladder also help keep the urethra closed.
When the bladder is full, nerves in your bladder signal the brain. That’s when you get the urge to go to the bathroom.
Once you reach the toilet, your brain tells the sphincter and pelvic floor muscles to relax. This allows urine to pass through the urethra. The brain signal also tells the bladder to tighten up. This squeezes urine out of the bladder.
Bladder control means you urinate only when you want to. For good bladder control, all parts of your urinary system must work together:
- Pelvic muscles must hold up the bladder and urethra.
- Sphincter muscles must open and shut the urethra.
- Nerves must control the muscles of the bladder and pelvic floor.
- Medicine for high blood pressure can cause bladder control problems.
How can medicines cause leaking?
Leaking can happen when medicines affect any of these muscles or nerves. For instance, medicines to treat high blood pressure may make the sphincter muscles too tight or too loose. Medicines to treat colds can have the same effect.
You may take medicine to calm your nerves so that you can sleep or relax. This medicine may dull the nerves in the bladder and keep them from signaling the brain when the bladder is full. Without the message and urge, the bladder overflows. Drinking alcohol can also cause these nerves to fail.
Water pills (diuretics) take fluid from swollen areas of your body and send it to the bladder. This may cause the bladder to leak because it fills more quickly than usual. Caffeine drinks such as coffee and cola have the same effect. Some foods such as chocolate also can cause bladder problems.
Will the doctor do tests?
You will probably have a physical exam. The exam can show the reasons for your bladder control problem. First, your health care team will look for a simple cause. It could be an infection in the bladder or urethra. This can be treated easily.
The reason for your problem may be harder to find. Then, the doctor or nurse may want to do some tests:
- Check to see how well the bladder muscles are doing their jobs.
- Take samples of urine and blood for tests.
- Look for something blocking the urine flow–like a stone, a growth, or hard bowel movement or stool.
- Take pictures of your bladder using special machines.
What can you do about your bladder control problem?
Your doctor needs to know what medicines you take. Before your next doctor’s visit, make a list of all the prescription medicines you take. Also, list medicines you buy without a prescription. Or, bring all your medicines with you to show the doctor. Ask your doctor if any of the medicines could cause your bladder problem. Your pharmacist can also give you information about your medicines.
You may have to continue taking a medicine that causes a bladder control problem. Ask your doctor to help you find another way to control your bladder. Other ways might include:
- Exercises for the muscles that close the bladder
- Devices to stimulate the muscles
- Training the bladder to hold more urine.
Points to Remember
Never stop taking a prescribed medicine without first talking to your doctor.
Certain medicines, foods, and drinks can cause bladder control problems.
Make a list of your medicines–both prescription and nonprescription–to show your doctor. Take the list to talk about bladder control.
You may have to keep taking important medicines, even if they cause some bladder control problems.
Do-It-Yourself Treatments:
Pelvic muscle exercises
You can learn simple exercises that can strengthen the muscles near the urethra. These are called pelvic muscle exercises, or Kegel exercises, and take only a few minutes a day.
Bladder training
You can train your bladder to hold urine better. Follow a timetable to store and release urine. You can also learn to decrease the urge to urinate.
Weight loss
Sometimes extra weight causes bladder control problems. A good meal plan and exercise program can lead to weight loss.
Food and drink
Some drinks and foods may make urine control harder. These include foods with caffeine (coffee, tea, cola, or chocolate) and alcohol. Your health care team can suggest how to change your diet for better bladder control.
Muscle Therapy
Electrical stimulation. Certain devices stimulate the muscles around the urethra. This makes the muscles stronger and tighter.
Biofeedback
This takes the guesswork out of pelvic muscle exercise. A therapist places a patch over the muscles. A wire connects the patch to a TV screen. You watch the screen to see if you are exercising the right muscles. The therapist will help you. Soon you learn to control these muscles without the patch or screen.
Medical Treatments
Medicines. Certain drugs can tighten or strengthen urethral and pelvic floor muscles. Other medicines can calm overactive bladder muscles.
Surgery. Some bladder control problems can be solved by surgery.
Many different operations can improve bladder control. The operation depends on what is causing the problem. In most cases, the surgeon changes the position of the bladder and urethra. After the operation, the bladder control muscles work better.
Soon, you will be able to buy new products. These products help control leaks. They do not cure the causes of bladder control problems.
Devices
Pessary–Your doctor can place a special device called a pessary (PESS-uh-ree) in the vagina. The device will hold up the bladder to prevent leakage.
Urethral inserts–Your doctor may give you a small device that goes directly in the urethra. You can learn to insert the device yourself. It’s like a little plug. You remove the device when it is time to go to the bathroom and then replace it until it’s time to go again.
Urine seals–This is a small foam pad you place over the urethra opening. There it seals itself against your body to keep urine from leaking. When you go to the bathroom, you remove the pad and throw it away.
Dryness Aids
Pads or diapers: Pads or diapers help many people, but do not cure bladder control problems. See a doctor or nurse, even if diapers are working for you.
Bedside urinal: Some people use a bedpan, a bedside chair urinal, or commode.
Assistance: If you are disabled, health care workers can help you move more easily to a toilet. Your doctor or nurse may teach you to urinate on a schedule that prevents wetting.
Renovations: Sometimes, you just need a carpenter to make changes to your house. Perhaps you need a hallway light, or a downstairs bathroom. Another solution could be widening a bathroom door to fit a wheelchair.
Points to Remember
- Many women have bladder control problems.
- Bladder control problems do not have to be a normal part of aging. Many medical conditions can cause bladder problems.
- Try not to let embarrassment about bladder control problems keep you from talking to your health care team.
- Most cases of poor bladder control can be improved greatly.
- Ask your health care team for help.