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Are you in control of your bladder?

Urinary incontinence affects millions of American’s, the majority women, but frequently goes unmentioned and unmanaged. Many assume that it is a normal part of aging while others may find it embarrassing or are unaware of the treatment options. A life with diapers or pads, skin breakdown, possible infections and odor does not need to be the only answer. The exciting news is that about 80 percent of all reported cases are cured or improved. 

General incontinence is described as a loss of bladder control due to a weak pelvic floor. A healthy pelvic floor contracts efficiently to hold urine and also relaxes appropriately so full bladder release is possible. A pelvic floor problem occurs when there is not enough strength or an inability for the muscles to relax. 

A weak pelvic floor may occur from pregnancy, trauma, surgery, a fall, poor posture and spinal alignment, muscle imbalances, infection or inflammation. A hyperactive pelvic floor may be due to a neurological disorder or trauma leading to damaged muscles and nerves in addition to the shortening and spasm of muscles due to pelvic misalignments or sustained contractions. 

A pelvic floor dysfunction may lead to three general types of incontinence which are stress, urgency and frequency.  Stress is leakage that occurs when you cough, sneeze, lunge or laugh. Urgency is the involuntary loss of urine due to an inability to hold urine when the bladder feels full. Finally frequency refers to multiple visits to the bathroom in a very short space of time. 

There are a variety of treatment options that may facilitate more bladder control and, like most things good for us, require discipline and commitment. One approach may be helpful but generally a combination of approaches will ultimately provide full recovery or improvement.

Behavioral therapy investigates both physical and mental activities or habits that may feed into the problem of incontinence. Often once destructive habits are identified and retraining of certain behaviors takes place, very powerful changes in bladder control occur. 

Diet is also an important component to incontinence, not only because some foods may irritate the bladder but also excessive weight puts unnecessary stress onto the pelvic floor. Obesity combined with inactivity leads to weakness and unfortunate incontinence. A lack of fiber and low fluid intake in a diet may cause constipation and bladder irritability which will also contribute to poor bladder health.

Exercise also plays a vital role in pelvic floor health, and maintaining strength and tone of the muscles in the pelvis contributes to bladder control. There are two different muscle types in the pelvic floor, those that are responsible for sustained contractions and maintain general bladder sphincter closure, combined with those that are responsible for quick contractions, needed when you sneeze or jump. It is important when training the pelvic floor muscles that long slow holds of the pelvic floor muscles are combined with quick contractions.  Pelvic floor strengthening is vital but must be combined with a general body exercise program for the full effect.

Bladder control and pelvic floor strength may be facilitated with the use of biofeedback techniques. This involves the use of an external indicator to provide information of internal pelvic floor strength. Biofeedback units may be used in the clinic or at home and will give individuals information about the strength and effectiveness of their pelvic floor contractions and their exercise program.

Finally, in addition to behavioral and biofeedback techniques, exercise and diet, medications and surgery do play a roll in controlling incontinence.