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Many people with bladder control problems hide this
problem from their doctor. Talk to your doctor, as most cases of urinary
incontinence can be treated and controlled, if not cured.
The doctor will give you a physical examination and
take your medical history and ask about your symptoms and if you are
on any medication for any illness or surgery. Your doctor also may do
urine and blood tests and a test that measures how well you empty your
bladder.
There are several different types of urinary incontinence:
Stress incontinence happens when urine leaks
during exercise, coughing, sneezing, laughing, lifting heavy objects,
or other body movements that put pressure on the bladder. It is the
most common type of problem in middle-age women. In some cases it is
related to childbirth. It may also begin around the time of menopause.
Urge incontinence happens when people can't
hold their urine long enough to get to the toilet in time. Healthy people
can have urge incontinence, but it is often found in people who have
diabetes, stroke, Alzheimer's disease, Parkinson's disease, or multiple
sclerosis. It is also sometimes an early sign of bladder cancer.
Overflow incontinence happens when small amounts
of urine leak from a bladder that is always full. A man can have trouble
emptying his bladder if an enlarged prostate is blocking the urethra.
Diabetes and spinal cord injury can also cause this type of incontinence.
Functional incontinence happens in many older
people who have normal bladder control. They just have a hard time getting
to the toilet in time because of arthritis or other disorders that make
moving quickly difficult.
The type of treatment depends on the type of problem
you have, how serious it is, and what best fits your lifestyle.
Bladder Control Training
Your doctor may suggest you try to get back control of your bladder
through training. With bladder training you can change how your bladder
stores and empties urine. There are several ways to do this:
Pelvic muscle exercises (also known as Kegel exercises) work
the muscles that you use to stop urinating. Making these muscles stronger
helps you hold urine in your bladder longer. These exercises are easy
to do. They can lessen or get rid of stress and urge incontinence.
Biofeedback helps you become more aware of signals from your
body. This may help you regain control over the muscles in your bladder
and urethra. Biofeedback can be used to help teach pelvic muscle exercises.
Timed voiding and bladder training also can help you control
your bladder. In timed voiding, you keep a chart of urination and leaking
to determine the pattern. Once you learn that, you can plan to empty
your bladder before you might leak. When combined with biofeedback and
pelvic muscle exercises, these methods may help you control urge and
overflow incontinence.
Besides bladder control training, there are several other ways to help
manage incontinence:
A doctor can prescribe medicines to treat incontinence. Some
drugs prevent unwanted bladder contractions. Some relax muscles, helping
the bladder to empty more fully during urination. Others tighten muscles
in the bladder and urethra to cut down leakage. These drugs can sometimes
cause side effects such as dry mouth, eye problems, or urine buildup.
Vaginal estrogen may be helpful in women after menopause. Talk with
your doctor about the benefits and side effects of using any of these
medicines for a long time.
A doctor can inject an implant into the area around the urethra.
The implant adds bulk. This helps close the urethra to reduce stress
incontinence. Injections may have to be repeated after a time because
your body slowly gets rid of these substances.
Sometimes surgery can improve or cure incontinence if it is caused
by a problem such as a change in the position of the bladder or blockage
due to an enlarged prostate. Common surgery for stress incontinence
involves pulling the bladder up and securing it. When stress incontinence
is serious, the surgeon may use a wide sling. This holds up the bladder
and narrows the urethra to prevent leakage.
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