So it happened. There was a gush of fluid. Probably urine? Many thoughts run through your mind. Is it still coming out? Did it go through my clothes? Does it stink? Will it last forever? Is something more serious going on? Is it going to get worse?
Relax. You are in good company. As many as 1 in 2 women and 1 in 4 men suffer from a leaky bladder. People just don’t talk about it. Ever. Not all urinary incontinence is the same. Depending on the issue, it can be a predictable annoyance or a catastrophic puddle.
Here are the most common kinds of incontinence.
Stress Incontinence- This is the spurt you get when you cough too hard or sneeze suddenly. This happens when the pelvic floor (those muscles that are supposed to keep your insides from falling out) becomes weak. If your bladder were a bag of water that is closed by a tie, the tie has become loose. Therefore, anything that squeezes the bag (lifting, running, jumping, laughing), is able to push the urine out. The amount of urine you lose depends on how loose that tie is. Anything that strengthens the floor (looking at you, Kegels) or tightens it (surgery, etc.) will improve your situation.
Urge incontinence- This is the “I-NEED-TO-GO-NOW-OR-I-AM-GOING-TO-PEE-MYSELF” kind of problem. It’s the clenching. It’s the curtzy. Again, if you imagine your bladder as a bag with a tie on it, the problem is now the bag. The bag is supposed to relax and stretch as it fills. Instead, before it’s full, the bag tells the brain, “STOP, I’m FULL” and the brain says, “Well, then EMPTY,” and so it does. Unfortunately, the bag and the brain leave you out of the conversation, so you start to pee before you are ready for it. Sometimes the muscles that make up the bag itself have become too stiff to stretch, so it can’t fill up like it is supposed to. You end up being the friend with the small bladder. We treat this by getting your bladder to chill out.
- You have both stress and urge incontinence. Ugh.
- Interestingly, this can be a problem of the bag or the tie. Instead of being overactive, sometimes the bladder becomes lazy and underactive (like in people with diabetes). Rather than squeezing all the time as above, it doesn’t squeeze at all. Another type of overflow can happen if the tie on the bag is too tight. This happens in men with prostate problems. Sometimes after surgery, the tie gets pulled too tight. So imagine you are now filling up the bag under a faucet. If the bag never empties, the water now overflows the top and out of the bag.
Bladder leaks are more common than you think.
When do you need to seek help for incontinence?
- You see blood in your urine.
- The change is sudden. You were normal yesterday, but not today.
- It is associated with pain and or fever.
- You cannot control your bowel movements either.
- Frankly, when it bothers you or interferes with your life. Incontinence isn’t something you have to just “deal” with.
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