Bladder Control/Urinary Incontinence
If you are experiencing symptoms of incontinence, the good news is that it is very treatable.
Maybe you find that you leak when you bend, lift, or even just cough and laugh. Or you might leak for no reason at all. Urinary incontinence is a common condition that happens more often in older men and can be short-term or long-lasting.
Incontinence can happen when:
- Your bladder muscles squeeze too hard or the muscles are weak, causing urine to leak out
- Your bladder doesn’t empty during urination, leaving too much urine in the bladder
- Your urethra is blocked, causing built-up urine to leak out of the bladder
- Incontinence can also be a side effect of prostate surgery, in which case it may clear up once you have recovered; or it may persist after prostate surgery
Understanding the different causes of incontinence can help you better understand the treatment plan that’s right for you.
What are the different types of incontinence?
Stress Urinary Incontinence (SUI)
If you have SUI, urine leaks out of the bladder when you’re active. This may happen when you are lifting, laughing, coughing or sneezing. Stress incontinence can be caused by weak bladder muscles, and can also happen after prostate surgery.
Also called “overactive bladder,” your bladder feels full even when it’s empty and you feel a sudden urge to urinate that you cannot control. Urge incontinence can be caused by infection, a nerve problem, or a growth in the bladder.
This happens when the bladder doesn’t completely empty and then fills up to overflowing. Urine might just trickle out and your bladder might never feel empty. This can be caused by a blockage in the opening to the bladder or the urethra. It can also be caused by nerve or muscle problems that keep the bladder from contracting.
Tips to control incontinence
There are some things you can try on your own to reduce the symptoms of incontinence.
- Avoid smoking
- Cut back on caffeine and alcohol
- Do simple muscle-strengthening exercises called “kegels,” contract and relax the muscles used to stop urine flow or gas passage. Practice contracting the muscles while you are sitting, e.g., while watching television commercials or at waiting at stop lights
- Practice what is called “double voiding” – urinate as much as you can, relax briefly, then urinate again
- Use “timed voiding” – follow a schedule of drinking fluids and urinating at set times during the day
Most cases of urinary incontinence can be successfully treated.
What to expect
Your doctor will complete a medical history and a physical exam; routine diagnostic tests, like urinalysis, can often give your urologist the information needed to move forward with a treatment plan. Because there are a number of different causes of bladder leakage, your doctor may suggest additional tests such as cystoscopy, or a series of tests (urodynamics study) to evaluate how well your urinary tract is working.
Your doctor will recommend the best treatment plan for you. Options may include both non-surgical and surgical treatments:
- Nutrition counseling: Certain foods, beverages, and ingredients can contribute to bladder irritation. Our specialists can work with you to evaluate your eating and drinking patterns to determine if changes could help your condition.
- Physical therapy: Many of the symptoms of urinary incontinence are caused by weakness in the pelvic floor muscles. Physical therapy can help these muscles build strength. Using this therapy in combination with biofeedback, a technique that trains you to control certain physiological processes, can be effective too. A computer monitors the strength of your pelvic muscles and tracks your progress throughout the therapy. It allows you to immediately see the results as you contract and relax these muscles to a pre-set pattern of exercises.
- Medication: medication can help the sphincter (the muscle that closes to keep urine from leaking) work better, and can also help stop the bladder from contracting too often.
- Catheter: a narrow tube is inserted through the urethra into the bladder to drain urine. Catheters can be prescribed to be worn most of the time or only at scheduled times.
- Minimally invasive microwave or laser treatments can be effective in reducing blockages, which are generally caused by an enlarged prostate.
If other options aren’t working for you, your doctor might recommend:
- Minimally invasive surgery: There are more minimally invasive options available than ever before. Talk to your doctor about whether this approach is right for you. Time away from your active daily life will be minimal.
- Other surgical procedures used to treat incontinence may include a male sling, artificial sphincter, or neuromodulation.
Need a Referral?
It helps to have a urologist from John Muir Health who knows your health history and can help you get the treatment that’s right for you more quickly.
For more information about our urology services, please call (925) 937-7740.