Q: I’m going on vacation soon and I’m worried about leaking urine due to incontinence. What should I do?
It may be a small drip after coughing or sneezing, or a major leak caused by a sudden need to urinate.
The urinary incontinence, or accidental loss of urine, is a common condition. It affects many more women than men and is more common among older adults, although it can occur at any age and for various reasons, he said. Harry Johnsonurogynecologist University of Maryland Medical Centerin Baltimore.
If this condition bothers you, keep in mind that there are many effective treatment optionsJohnson said. In addition, there are useful products to control urine leakage on the go.
One of the most common types of urinary incontinence is stress incontinencewhich occurs when pressure is put on the bladder (for example, when coughing, sneezing, laughing or jumping) and urine leaks, he explained Linda McLeanprofessor of physiotherapy at University of Ottawa, Canada. Stress incontinence is usually caused by damage to the muscles or supporting tissues of the urethra, or to the valve between the bladder and urethra, Johnson said.
Another common way is urge incontinence, which occurs when you feel the need to urinate even though your bladder is not full, Johnson said. It is usually the result of nerve injuries that affect the brain’s control of the bladder. In this type of incontinence, the urge can be so strong and sudden that hearing water running, washing your hands, or even opening the door at home can cause spontaneous loss of urine.
In both women and men, the risk of incontinence increases with age. Men tend to suffer from urge incontinence, often caused by an enlargement of the prostate, although prostate surgery can cause stress incontinence. Women suffer from both types more often than men, in part because pregnancy and childbirth can damage nerves and weaken the muscles and connective tissues that support the pelvic organs.
People with mobility problems or chronic diseases such as multiple sclerosis, diabetes, or a stroke They can also suffer accidental losses.
According to Johnson, certain dietary modifications are worth trying first. Reduce caffeine and alcohol consumption, that increase urine production, may be helpful. And pay attention to how much water you drink: Both too much and too little can exacerbate the problem, McLean said.
The pelvic floor physiotherapy, which includes Kegel exercises, is effective for both men and women. Also beneficial is bladder training, which involves gradually increasing the time between trips to the bathroom by 15 minutes or so until you can last two or more hours, Johnson said.
The anticholinergic drugs – which block receptors in the bladder to reduce contractions and therefore leaks – are useful for some people. However, McLean noted that these drugs have been linked to an increased risk of dementia in older adults, so they should be carefully considered.
In the case of stress incontinence, minimally invasive proceduressuch as injecting volumizing agents into the urethra or surgically inserting a sling under the urethra to help support it, can help prevent leakage.
In the case of urge incontinence, injecting Botox into the bladder stiffens the muscles of the organ, making it more difficult for them to contract and cause leaks. And the neuromodulation sacral surgery involves surgically implanting a device that sends electrical impulses to the nerves related to bladder function.
What works for you won’t work for everyone. But most people will be able to find at least one treatment option that reduces or eliminates their urine leakage, Johnson said.
Prepare to quickly get to the bathroom. Identify public bathrooms beforehand, for example, with a bathroom locator app, said Paul Pettit, a urogynecologist at the Mayo Clinic. When traveling by plane, opt for an aisle seat; On long car trips, consider bringing a portable toilet.
In the last decade, incontinence products have improved greatly and are much easier to find, McLean said.
The National Continence Association maintains a list of effective products, including portable catheters for men that fit like a condom and absorbable pads, liners and underwear. Intravaginal inserts, such as pessaries, can be placed in the vagina to put pressure on the urethra and help reduce leakage. “Not all people like them,” McLean said. But “when they work, they work very well.”
Lastly, have a backup plan in case of an accident. Wear loose, dark clothing to hide wet stains, and bring a change of clothes and plastic bags to store dirty ones.
And remember: coping with urinary incontinence doesn’t have to be a lonely or embarrassing task. There are many resources and options designed to alleviate worry and improve your quality of life, Pettit said.
©The New York Times 2024
