January 7, 2021
Clinical Contributors to this Story
Nina Bhatia, M.D. contributes to topics such as Urogynecology.
“Oops! I just peed myself, a little.” Many women jokingly say this phrase while laughing at something funny, but bladder leakage, also known as urinary incontinence, is no laughing matter. Constantly worrying that you will leak urine from something as simple as laughing, sneezing or coughing can affect your daily activities, cause you to avoid socializing with friends or participating in activities that cause a fear of not being able to get to the bathroom in time. All of this emotional stress can leave you feeling embarrassed. With so many bladder leakage products and treatment options, how do you know what is the best one for you?
First, be sure to check in with your urologist or urogynecologist to see what may be causing your bladder leakage. Knowing the cause will help you and your doctor decide what treatment option will work best for you. While certain drinks, foods and medications may stimulate your bladder, there are other medical reasons that can cause your symptoms, including:
- Urinary tract infections
- Weakened pelvic floor, sometimes caused by pregnancy, childbirth, menopause or having had a hysterectomy
- Neurological disorders
“Depending on what is causing your urinary incontinence, a unique treatment plan should be developed based on your personal situation,” says Nina Bhatia, M.D., urogynecologist at Hackensack Meridian Health. “There are several lifestyle changes, including bladder retraining techniques, dietary changes, avoiding bladder irritants, pelvic floor exercises and pelvic floor physical therapy that can help tremendously. If those fail to provide you relief, there are non-surgical and surgical options that we can offer.”
So, what are my treatment options?
Your doctor may recommend:
- Bladder training, to delay urination after you get the urge to go. You may start by trying to hold off for 10 minutes every time you feel an urge to urinate.
- Double voiding, urinating, then waiting a few minutes and going again to fully empty the bladder.
- Scheduled toilet trips, urinate every 2 to 4 hours rather than waiting for the need to go.
- Fluid and diet management
Pelvic floor muscle exercises
Also known as Kegel exercises, these exercises are especially effective for stress incontinence but may also help urge incontinence. To do pelvic floor muscle exercises, imagine that you’re trying to stop your urine flow. Then:
- Tighten (contract) the muscles you would use to stop urinating and hold for five seconds, and then relax for five seconds. (If this is too difficult, start by holding for two seconds and relaxing for three seconds.)
- Work up to holding the contractions for 10 seconds at a time.
- Aim for at least three sets of 10 repetitions each day.
Medications commonly used to treat overactive bladder, urge or overflow incontinence, include:
- Anticholinergics – blocks chemical messages in the brain that causes involuntary muscle movements in the urinary tract
- Mirabegron (Myrbetriq) – treats over-active bladder by relaxing bladder muscles to allow it to fill more completely before signaling the need to be emptied
- Alpha blockers – assists in strengthening the bladder sphincter and reduce bladder leakage
- Topical estrogen – helps restore deteriorating tissue in the vagina and urinary tract which in turn relieves some incontinence symptoms
Absorbent pads, catheters and medical devices
If medical treatments can’t completely eliminate your incontinence, you can try products that help ease the discomfort and inconvenience of leaking urine:
- Pads and protective garments
- Pessaries and vaginal inserts – a small device inserted into the vagina to help provide support to prevent leakage
In office, non-surgical options
- Bulking material injections
- Botulinum toxin type A (Botox)
- Nerve stimulators
“Unwanted bladder leakage can often be treated with simple, minimally invasive in-office procedures,” says Dr. Bhatia. “These procedures are very well tolerated in the office, with only local anesthetics, and with little to no down time. Patients can resume their usual activities the same day. Patients with pelvic organ prolapse can also benefit from in-office pessary placement as a non-surgical option.”
When other treatments are not providing the relief you need for bladder leakage or prolapse, there are surgical options to treat these conditions, including minimally invasive vaginal, laparoscopic and robotic surgical options. Many surgeries for incontinence can be done under a light sedation, avoiding the need for general anesthesia.
When should you see a doctor?
“If a patient is suffering with symptoms of pelvic organ prolapse, or loss of bladder or bowel control, I would encourage them to schedule an evaluation,” says Dr. Bhatia. “Pelvic floor dysfunction is not a normal part of aging. In fact, one-third of all women will experience a pelvic floor condition within their lifetime, yet millions suffer in silence and often wait one to five years before seeking help. While it impacts millions of women, there is almost always a therapy that can significantly improve, if not cure these symptoms. My patients frequently say ‘I have my life back’ after having these conditions treated.”
Next Steps & Resources:
- Meet our clinical contributor: Nina Bhatia, M.D.
- To make an appointment with Dr. Bhatia, or a doctor near you, call 800-822-8905 or visit our website.
The material provided through HealthU is intended to be used as general information only and should not replace the advice of your physician. Always consult your physician for individual care.