Dealing with Bladder Control Issues

Incontinence is a condition that is often associated with the very young and the sick, but not always. If you’re living with incontinence, you may be looking for ways to control or at least mitigate the situation so that you don’t have to base your life around it. Good news… you can regain control of your life and your body! Before we get into ways to help lessen the incontinence problems in your life, we need to discuss a few things first.

Nothing to Be Ashamed Of

If you’re living with incontinence, you’re certainly not alone. One 2018 study found that as many as half of all women over 50 live with incontinence, but many don’t report it to their doctors. A 2014 study had similar results, finding half of all seniors deal with one form of incontinence or another.

Millions of Americans deal with incontinence every day, so there’s nothing to be ashamed of.

If you’re struggling to control your urination or defecation, speak to your doctor. Allowing incontinence to go unreported with your doctor can allow the subsequent consequences to your quality of life and mental health to go untreated. More importantly, it may be a sign of an underlying condition that needs treatment.

Understanding the Causes of Incontinence

Dealing with incontinence often starts with the search for an underlying condition. You could treat the symptom of loss of bladder control, but if you’re not taking care of the cause, it may be just a band-aid. The incontinence could continue, especially if caused by a chronic underlying condition. Once your doctor has diagnosed the cause of your incontinence, you can then begin to treat the condition.

In our post “Common Causes of Incontinence in Seniors,” we discuss both what incontinence is and the different health conditions and factors that can lead to it. If you’re curious, we encourage you to check out the article. For a quick, handy way to think of the different causes of incontinence, remember the pneumatic device DIAPPERS:

• Delirium: Delirious patients, with a brain disorder, may not even be aware their bladders are full
• Infection: Specifically, a urinary infection like a UTI (urinary tract infection)
• Atrophic conditions: These irritate or weaken tissues involved in the elimination process
• Pharmaceuticals: Some drugs may cause incontinence as a side effect
• Psychological disorders: There are a number of tangential psychological factors that can lead to incontinence
• Excessive urine output: More urine means more stress on your system, raising the chances of leaks
• Restricted mobility: If you struggle to make it to the bathroom, leaks may become more common
• Stool impaction: There are a few ways that constipation can cause incontinence

Treatments and Strategies for Living with Incontinence

In some cases, there may not be an underlying condition or solution for your incontinence — your muscles may just be weakening, for example. Even if there is a condition causing it, you’ll still need to deal with the incontinence while you undergo treatment. So, what are some ways you can handle the control issues?

Medical Options

The most invasive of medical treatments for incontinence are the surgical options, of which there are several. Each surgical solution is specific to the type of incontinence. For example, sling procedures implant a sling near the urethra that helps keep it closed under mild stress. You could also get an artificial urinary sphincter that helps keep the bladder closed until you need to use the bathroom, when you push a small, implanted valve that deflates the implant and allows you to go.

Other possible treatment options include electrical stimulation, which can help give you more control over your bladder.

Alternatively, your doctor may prescribe certain medications. For example, for overactive bladders, you may be given an anticholinergic, which blocks the messages from signaling to your brain associated with an overactive bladder. A mirabegron can help your bladder hold more urine while also allowing you to empty it more fully when you do use the bathroom. If your incontinence is related to menopause, your doctor may prescribe estrogen.

Other possible treatment options include electrical stimulation, which can help give you more control over your bladder; an injectable bulking agent, placed around the urethra to strengthen it; or Botox injected into the bladder to help combat urge incontinence.

Lifestyle Changes

Outside of the medical options, there are changes you can make in your life that may help either lessen your chances of having an accident or limit the downsides if one happens. A great place to start is planning your day ahead. This can help ensure that you’re usually close to a bathroom and can make regular stops so you can go before you need to. You can further limit your risk of an incident by wearing an incontinence pad. They generally fit snuggly under your pants and are about as thin as the average pair of underwear, making them generally undetectable.

Your doctor may have you begin doing exercises that can strengthen your muscles that control urination, called Kegel exercises.

Furthermore, you can also work with your doctor to rethink your diet, either looking for foods that trigger your incidents (like spicy or caffeinated food and drink) or simply reducing your liquid intake to lessen the pressure on your bladder. Your doctor may have you begin doing exercises that can strengthen your muscles that control urination. These are called pelvic floor muscle exercises, or Kegel exercises, and can be effective for both men and women.

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Incontinence can make you feel ashamed of your loss of control over a central function of your body. While we contend it’s nothing to be ashamed of, it can be a good idea to try to regain some control so that the problem doesn’t control you. Between working with your doctor and making subtle lifestyle changes, you should be able to go about your life without too much of an interruption.