Family Planning - Urinary Problems

Urinary incontinence in women

 

Leaking urine at the wrong time is an extremely common problem, and many people are too embarrassed to seek help. However there is a lot that can be done to improve symptoms. For general information, this is an excellent website:

http://www.bladdermatters.co.uk/

There are two main types of urinary incontinence – ‘Stress Incontinence’ and Urge Incontinence’. Some people have a mixture of the two, and there are rarer causes also.

1) Stress Incontinence – this is leaking when you cough or sneeze. Sometimes it can be on laughing or when you exercise. 1 in 5 women over the age of 40 are thought to be affected. The main cause is weak pelvic floor muscles. These are muscles that help control your bladder and bowels. They can become weak with age and time, or following normal child birth.

For further information – click http://www.patient.co.uk/health/stress-incontinence

 

2) Urge Incontinence – this is the sudden need to go to the toilet, and you may not always get there in time before leaking. This is caused by the bladder contracting too early, and there are many reasons why this may occur.

For further information – click http://www.patient.co.uk/health/urge-incontinence

 

If you are suffering with incontinence and would like some help, then please book an appointment to discuss with a GP. It would be very helpful to bring along a urine sample (in a clean container) and a completed bladder chart. A bladder chart records how much and what you drink on a normal day, how much you are passing urine, and how often you leak. Please download the 24 hour bladder chart here:

http://www.lion-health.co.uk/images/uploads/pdfs/24_Hour_Bladder_Diary.pdf

The GP will listen to your symptoms and may want to examine you further. If you haven’t already provided a urine sample and done a bladder chart, you will be asked to complete these. It may sometimes also involve a pelvic vaginal examination.

 

What can be done to help yourself?

It depends on the type of incontinence you have, but there are lots of things you can do to help yourself.

1) Changing what you drink: Certain drinks irritate the bladder, and stopping or reducing these may make a big difference for many people.

Food and drinks which can irritate the bladder:

  • Caffeinated drinks - tea, coffee, hot chocolate, green tea
  • Blackcurrant juice
  • Citrus fruit and juices
  • Tomatoes
  • Cola and other fizzy drinks
  • Alcohol

Drinks which don't irritate the bladder:

  • Water
  • Milk
  • Decaffeinated drinks
  • Herbal teas
  • Milk shakes
  • Diluted fruit juice

 

2) Pelvic floor exercises – especially for stress incontinence. For further advice and how to do these, click here:  http://www.patient.co.uk/health/pelvic-floor-exercises

3) Changing the time you drink – reduce the amount you drink late at night may help the number of night time toilet trips. 
4) Weight loss: even a 5-10% weight loss can help symptoms in overweight and obese people.
5) Avoid constipation, as this can prevent the bladder from emptying properly. Aim for a healthy diet with plenty of fruit, vegetables and fibre.

 

What else can be done?

1) There are medications that can be helpful, especially for urge incontinence symptoms. These will be discussed with you, if appropriate.
2) Continence advisor – this may be helpful for some people, especially if it is not clear what type of incontinence you may. They can also teach about bladder retraining for urge incontinence, or teach about pelvic floor exercises for stress incontinence symptoms.
3) Surgery for stress incontinence is an option if your symptoms have not settled with at least a 3 month trial of simple measures and pelvic floor exercises first.