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Bladder control: Sensible solutions for a sensitive subject

If you sometimes are embarrassed by problems with bladder control—you leak urine or can’t make it to the restroom on time—it may be comforting to know that your condition is not uncommon. According to the U.S. Department of Health and Human Services, approximately 13 million Americans suffer from an overactive bladder or incontinence. Even more important: Your doctor can treat you so you no longer have to suffer your condition’s embarrassment and inconvenience.

Who’s affected?

Bladder control problems can happen to anybody at any age and include a variety of physical complaints:

  • If you have to urinate more than eight times over a 24-hour period or the urge to urinate is immediate and strong or occurs soon after emptying the bladder, you may have an over-active bladder. A malfunctioning muscle that surrounds your bladder causes this condition.
  • If you leak urine when you cough or sneeze, you have stress incontinence, the most common bladder control problem for women of all ages. Exercising, lifting heavy objects or moving in a way that puts sudden pressure on the bladder can also cause stress incontinence.
  • When you can’t hold your urine long enough to make it to the toilet in time, you have urge incontinence—a common problem for older women; people with Alzheimer’s disease, Parkinson’s disease or multiple sclerosis; or anyone who’s suffered nerve damage from stroke or diabetes.
  • When your bladder is always full and regularly leaks small amounts of urine, you have overflow incontinence, which can trouble people with diabetes or spinal-cord injuries.
  • If arthritis or other mobility challenges prevent you from making it to the bathroom in time, you may suffer from functional incontinence.

Treating your problem

Seeing your doctor or gynecologist is an important first step (he or she may then refer you to a urologist for treatment). Your doctor will ask questions to determine what’s causing your problems and may ask you to keep a diary, recording the times you urinate and the times you leak. Your solution may be as simple as restricting coffee, which is a diuretic, and performing Kegel exercises, which strengthen weakened pelvic-floor muscles that regulate urine flow. Or your doctor may prescribe vaginal inserts to help hold in urine or medication to help tighten or relax bladder muscles or prevent bladder contractions.

Other treatment options include mild electrical stimulation, biofeedback methods to improve muscle control and bladder training to strengthen your bladder and help you avoid accidents.

In some cases, doctors recommend surgery to strengthen muscles, move your bladder or narrow your urethra to prevent leakage. Your doctor may also use collagen implants that thicken the area around the urethra to help control urine flow or an implanted device to help control bladder contractions.