What
is urgency incontinence?"Incontinence" is the medical term for leaking urine
or losing control of your bladder. People with urgency incontinence feel a
strong need or "urge" to urinate all of a sudden. Often, it is so
strong that they can't make it to the bathroom in time. "Overactive
bladder" is another term for having a sudden, frequent urge to urinate.
People with overactive bladder might or might not actually leak urine.
Urgency
incontinence is common, especially in females. But there are treatments that
can help. There are also things that you can do on your own to stop or reduce
urine leakage. You don't have to "just live with it."
Is
there anything I can do on my own to prevent urgency incontinence?Yes. To help reduce
urine leaks or urges, you can:
●Cut down on any foods or drinks that make your symptoms worse.
Alcohol, caffeine, spicy or acidic foods, or artificial sweeteners make some
people urinate more often or cause sudden urges.
●Try not to drink too much right before bed.
●Prevent constipation – Constipation is a common problem that
makes it hard to have bowel movements. It can make urgency incontinence worse.
To help
with bladder control, you can try:
●Bladder retraining – Bladder retraining helps your bladder hold
more urine so that you can urinate less often. During bladder retraining, you
go to the bathroom at scheduled times. For example, you might decide to go
every hour. Make yourself go every hour, even if you don't think that you need
to. If you need to go sooner, try to wait until the whole hour has passed.
After you get used to waiting 1 hour, you can try waiting longer between
bathroom visits. Over time, you might be able to "retrain" your bladder
to wait 3 or 4 hours between bathroom visits.
●Relaxation can help manage the urge to go. When you get an urge,
stand still or sit down. Take a deep breath, squeeze your pelvic muscles, and
let the "wave" of needing to go pass. Then, walk slowly to the
bathroom to urinate.
●Pelvic floor muscle training – This involves learning exercises
to strengthen and relax your pelvic muscles. These include the muscles that
control the flow of urine and bowel movements. These exercises can help, but
people often do them wrong. Ask your doctor or nurse how to do them correctly.
They might suggest working with a physical therapist who has special training
in these exercises.
How
do doctors treat urgency incontinence?In addition to bladder retraining,
relaxation, and pelvic muscle exercises, treatment might include medicines and
sometimes procedures. These include:
●Medicines to relax the bladder – These can help
control symptoms. Medicines include oxybutynin (brand name:
Ditropan), tolterodine (brand name: Detrol), fesoterodine (brand name: Toviaz), solifenacin (brand name: VESIcare), darifenacin (brand name: Enablex),
and mirabegron (brand name: Mirbetriq). They
come in pills that you take by mouth, and patches or gels that you put on your
skin.
Medicines for urgency incontinence can cause side effects,
including:
•Very dry mouth
•Constipation
•Heartburn
•Trouble thinking and remembering things
•Blurry vision
•Fast heart rate
•Sleepiness
If you are older, ask your doctor if it is safe to take these
medicines. If you have any trouble thinking or remembering things, some of
these medicines could make these issues worse.
If you take medicine to help with urgency incontinence or
overactive bladder, you might need to try several different medicines before
you find a treatment that works for you.
●Vaginal estrogen – If medicines that relax your bladder do not work for you
or cause too many side effects, talk to your doctor about other treatments. For
some people who have vaginal dryness after menopause, vaginal estrogen can help
with this as well as your bladder problems.
●Procedures to help relax the bladder – If medicines
don't help your symptoms or you can't take medicines, your doctor might suggest
a procedure such as:
•An injection (shot) of botulinum toxin (Botox) into the bladder
to help it relax – The injection needs to be given about once or twice a year.
These injections can cause trouble urinating in about 1 out of 4 people who get
them.
•Treatment with electrical nerve stimulation – This is done with
a device that goes under the skin, like a pacemaker. Electrical stimulation
sends mild electrical signals to nerves that affect the bladder. The signals do
not hurt. This treatment can reduce sudden urges or the need to urinate often.
You might need follow-up procedures after getting the device put in.
How
well do treatments for urgency incontinence work?That depends on your
symptoms and the cause of your urgency incontinence. For example, if you have
another medical condition, such as diabetes, treating that condition might
help.
Most people
need to try several treatments and might use more than 1 at a time. For
example, your doctor might suggest bladder retraining, medicine to relax your
bladder, and vaginal estrogen. It can take a month or longer to know if a
treatment is working. Try not to get discouraged if it feels like treatment is
not working quickly enough.
What
will my life be like?Most people with urgency incontinence need some kind of
treatment for a long time, or for life. Treatment for urgency incontinence can
help symptoms, but does not cure the cause of the incontinence.
Even if
treatment doesn't stop urgency incontinence completely, it can make life easier
and help you feel a lot better.