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New ways to stay dry

» Four kinds of incontinence

» Why it happens

» New answers

» If you have a problem

Self-help measures

  • Do Kegels. Pull in the same muscles you would use to stop urinating midstream; hold for 10 seconds and repeat 10 times. Do three sets a day.
  • Train your bladder to last longer between trips to the ladies’ room. Start by urinating every two hours, whether you feel the urge to go or not. Every other day, extend the interval by 30 minutes. Your goal should be to wait four hours between bathroom visits.
  • Avoid caffeine, alcohol, spicy foods and artificial sweeteners. These can irritate the bladder.
  • Stop smoking. It irritates the bladder lining and damages nerves.
  • Cross your legs. We mean it! If you have stress incontinence, crossing your legs when you feel a sneeze or a cough coming on can prevent leakage.

It’s an uncomfortable sensation experienced by millions of women at some point. They lift a heavy carton, have a coughing fit or do a jumping jack—and urine escapes. Or maybe they barely get to the bathroom in time—that’s how strong and sudden their urge to urinate is. For some women, urinary incontinence is so persistent it forces them to think twice about engaging in certain activities.

Unfortunately, many women never mention this “personal” problem to their doctors. They falsely assume urinary incontinence can’t be helped or that it is simply a normal part of growing older.

However, self-help steps (see sidebar), innovative medical devices and FDA- approved surgical techniques can help women lead active lives without worrying about embarrassing leaks.

Four kinds of incontinence

The most common type of incontinence, called stress incontinence, happens when a sudden movement, a cough or a laugh forces urine out. Another type, called urge incontinence, is characterized by an immediate need to urinate. Often a woman with urge incontinence doesn’t make it to the bathroom in time. Overflow incontinence occurs when the bladder fails to empty completely, causing the remaining urine to dribble out. Finally, women who have any combination of types are said to have mixed incontinence.

Why it happens

Many factors may weaken the pelvic floor muscles and contribute to urinary leakage, including childbirth, excess weight, a chronic cough, chronic constipation and the lack of estrogen after menopause. Some illnesses, such as Parkinson’s disease or diabetes, can damage the nerves that regulate bladder function. Medications for high blood pressure, depression and heart disease also may cause incontinence.

New answers

Self-help measures are often adequate for women with mild incontinence, but women with more severe cases may benefit from these devices approved by the Food and Drug Administration:

  • Urethral plug. This balloon-tipped cylindrical device, about 1/5 the size of a tampon, is first inserted into the urethra, the slender tube that carries urine out of the body from the bladder, and then inflated to prevent urine from escaping. The plug, available by prescription only, must be removed before urination and a new one must be reinserted after urination.
  • Urethral patch. This small triangular patch has a gel-like backing that adheres to the opening of a woman’s urethra. Like the plug, the patch is available by prescription only and must be removed before urination.
  • Bladder neck prosthesis. Inserted into the urethra, this prescription device helps keep the bladder neck in place and prevent leaks. The prosthesis can remain in place during urination but must be removed periodically for cleaning.
  • Surgical solutions. When incontinence prevents women from enjoying a normal life, doctors may recommend one of several surgical techniques designed to support and/or reposition weakened structures, replace a defective urethral sphincter or remove obstructions. Another option is injecting a bulking agent, usually collagen, into the lining of the urethra. The substance helps the urethra stay closed, increasing its resistance to urine flowing from the bladder. Still another solution requires implanting a stimulator in the spine. The device sends small electrical impulses to the nerves that control bladder contractions.
  • Medications, too. Certain medications may relieve incontinence by increasing the bladder’s urine capacity or blocking bladder contractions. Others may tighten the muscles around the urethra.

If you have a problem

Don’t let shyness prevent you from speaking up about incontinence. Work with your doctor to come up with the solution that suits you best.

© 2014 Dowden Health Media