Coping with bladder problems
It is a subject that many try their hardest to ignore but bladder problems affect both women and men. It is also possible, in many cases, to ease the symptoms or even cure the problems completely.
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If you are concerned about your bladder health or are struggling with urinary incontinence here are some of the key symptoms, treatments and tips on how to cope.
Urinary incontinence is possibly more common than you think - according to the NHS, it is thought to affect more than 50 million people in the developed world.
Though the exact number of UK sufferers is unknown, it generally affects twice as many women as men and becomes more common as we age. There are also various different types and causes.
Stress incontinence
Common in women, often as the result of pregnancy and childbirth, this causes an involuntary leak usually when exercising, coughing, sneezing or laughing.
Urge incontinence
As the name suggests, the symptoms are a frequent and sudden urge to urinate (often during sleep or whilst drinking), it is also known as spastic or overactive bladder. Most common in older adults, the need to urinate more than seven times each day or more than twice during the night point to this type of incontinence.
Among the causes are stroke, cystitis and diseases of the nervous system, while those who have had a caesarean section, hysterectomy or prostate removal may be at greater risk. It can also be a symptom of urinary infection.
Overflow incontinence
This involves an inability to completely empty the bladder, leaving sufferers with a frequent urge to urinate or trying to cope with a constant dribble, sometimes both. Often the result of weakened bladder muscles, nerve damage from diabetes and other diseases is a known cause. However, it can also occur when kidney or bladder stones, or sometimes tumours, block the urethra.
Mixed incontinence
It is sometimes the case that a person suffers from two types of incontinence at the same time - most often stress and urge incontinence. It most commonly affects women and the two types may or may not be related.
Treatments
How incontinence is treated depends on the type and severity of the symptoms.
In general, a sufferer will be advised to try a few lifestyle changes first, notably pelvic floor muscle training (which aims to strengthen the muscles), bladder training (which includes pelvic floor muscle training as well as techniques to help you gradually increase the length of time between feeling the need to urinate and passing urine), and changes to your diet (such as cutting down on caffeine and drinking the correct amount of water).
However, if these changes do not help, your doctor may consider medication or even surgery.
Duloxetine, usually prescribed for stress incontinence, works by affecting the chemicals used to carry messages to and from the brain, while also increasing the urethra's muscle tone. However, it is not recommended for the elderly, those with heart disease or high blood pressure and pregnant or breastfeeding women.
For those with urge incontinence or an overactive bladder, antimuscarinic medication may be prescribed. Some antimuscarinics are available in tablet or patch form and your GP will generally start with a low dose that can be increased until it becomes effective.
In women, an overactive bladder may be caused by vaginal atrophy and in these cases, the doctor may prescribe a hormonal medication.
If all else fails, surgery may be recommended. There are various procedures and if surgery is your only option it is essential that you discuss fully the risks and benefits associated with a specialist.
Where to get help
Embarrassing as it may, it is important to seek help if incontinence begins to affect your quality of life and a visit to your GP should be the first port of call.
However, urinary incontinence can affect your mental as well as physical wellbeing, with many sufferers lacking in self-esteem and increasingly feeling isolated and depressed so don't be afraid to talk to family or friends who may offer some much-needed support.
If you would prefer to speak to someone outside the family, the Bladder and Bowel Foundation offer a wealth of information via their website and advice or a sympathetic ear via their counsellor helpline.
Visit www.bladderandbowelfoundation.org or call the confidential helpline on 0847 345 0165.
