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Slideshow: Reducing Incontinence Embarrassment

You're Not Alone

Don’t let fear of bladder accidents keep you from an active life filled with work, friends, and family. Incontinence is nota normal part of aging, nor is it something you just have to live with. There are plenty of things you can do. The sooner you call your doctor, the faster you can get treated.

 

First Steps

It’s not easy to talk about incontinence. That's why women wait, on average, 6 years before they get help. Take the first step and call your doctor. He might refer you to a urologist, gynecologist, or urogynecologist who treats urinary conditions. At your first visit, ask if your diet, health conditions, or medications could be causing the problem.

What Type of Incontinence Is It?

Before your doctor can treat incontinence, he needs to know what type it is and what's causing it. Menopause and childbirth (in women), prostate problems (in men), medication, and obesity can all play a part. If you release urine when you cough, laugh, or sneeze, that’s stress incontinence. If you have a sudden need to go before leakage happens, that's urge incontinence. These are the most common types. Some people have a combination of the two. Overactive bladder (OAB) makes you feel like you have to go often and urgently.

Your Doctor Visit: What to Expect

The doctor will examine you and ask about your health, symptoms, medicines you take, and the type of accidents you have. He might suggest you keep a diary to record every time you go to the bathroom or have wetness.

Tests to Diagnose Incontinence

Tests can evaluate your symptoms and help rule out any medical conditions. Your doctor may order urine studies to check for infections or other problems, as well as a bladder stress test. 

Your Options: Kegels -- Bladder Exercises

Squeezing muscles you already use several times a day can help prevent leaks. Kegel exercises work the pelvic muscles -- the same ones you use to start and stop the flow of urine. To do a Kegel, you squeeze and hold these muscles for about 10 seconds. Then release. Do about about 3 sets 3-4 times a day for a few weeks.

Your Options: Bladder Retraining

Want more control over your bladder? Retrain your bladder by scheduling your bathroom visits at regular intervals -- for instance, every 2 hours. If you have to go before your scheduled time, use Kegels or relaxation techniques to hold it in until the urge passes. Over time, you'll train yourself to go less frequently, with longer and longer intervals between bathroom breaks.

Your Options: Medicine

Drugs can treat urges related to overactive bladder. Some control its contractions, others keep it relaxed. Side effects include dry mouth, fatigue, and blurred vision. Men with prostate-related incontinence can try drugs that relax the prostate and bladder neck or shrink the prostate.

Your Options: Other Treatments

Women with stress incontinence can insert a pessary device into the vagina. It presses against the bladder neck and urethra to control leakage. Another option: Inject collagen and other bulking substances to thicken tissues around the bladder neck and narrow the opening. Or you can try sling or suspension surgery, which lifts the urethra and bladder neck back into place. For urge incontinence, painless nerve stimulation can stop your body from telling you your bladder is full.

Men and Incontinence

Men can become incontinent after illness, injury, or an enlarged prostate gland that blocks the regular flow of urine from the bladder. Like women, men can get relief from bladder retraining, lifestyle changes, and Kegels. There are also medicines and surgical treatments, like artificial sphincters or male slings, which support the urethra and keep it closed when necessary.

Pick Your Protection

You can buy products designed for bladder protection in stores and online. Disposable and reusable versions are offered. Some are specially fitted for men or women. For light to moderate wetness, a liner or pad that attaches to your underwear may be all you need. Fitted briefs or protective underwear can handle more liquid.

Get Back Out Into the World

A few routine changes can help prevent leaks and get you back to your favorite activities. Don't stop drinking fluids -- you'll become dehydrated. Limit each drink to 6 to 8 ounces, and don’t drink within 2 to 4 hours of bedtime. Avoid caffeine, alcohol, and artificial sweeteners, which can increase the urge to go. If you're overweight, losing weight will ease pressure on your bladder. And stamp out cigarettes -- smoking can affect your bladder, too.

Reducing the Embarrassment of Incontinence

Reviewed by Brunilda Nazario, MD on August 15, 2014

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Quick Fact

Stress and Urge Incontinence

What is stress and urge incontinence? Stress incontinence involves urine leakage during activity such coughing or laughing. Urge incontinence involves urine leakage at unexpected times and a sudden urge to go, such as when hearing running water.

Incontinence Embarrassment

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