Urinary incontinence affects 200 million people worldwide(1).
If you’re suffering from chronic urinary or bladder problems, you may experience trouble falling asleep, embarrassing dribbling incidents, or have to buy special pads or clothing.
You may have to plan your diet, your movements, and even your entire day around these issues.
BUT YOU ARE NOT ALONE…
Urinary incontinence occurs when the bladder involuntarily releases urine at unexpected and inconvenient times. Not only does this have a negative effect on your personal hygiene but it affects your social life as well.
Each day is a challenge with urinary incontinence. Among other problems, your days are plagued with frequent and sporadic leaks. Basic movements like stretching, bending, and lifting objects might cause unexpected leakage.
Sleep is often replaced with tossing and turning - you may be lying in bed with your eyes closed, but you're awake with the hope that you will drift off into sleep before the next urge strikes.
Unfortunately, urinary incontinence is a problem that is immediately noticeable - yet not a problem that many people really understand.
The average person doesn’t even know how urination works...
For most, the process is automatic and effortless - relief comes swiftly and most will simply walk away from a bathroom trip without a second thought...
But, of the staggering number of people who suffer from urinary incontinence, 25 million of them are adults living in the U.S.(2) - and the risk of urinary incontinence increases with age.
Taking proper care of your bladder can help those who are currently suffering from symptoms of urinary incontinence, and may even help prevent future problems for those who are at risk of urinary incontinence as they get older.
From the Stomach to the Kidneys to the Bladder
After consumption and the digestion process, your kidneys will work at filtering the newly introduced substances into the bloodstream. After the filtration process, the kidneys send urine through two ureters to your bladder for storage...
As this happens, the detrusor muscle lining the wall in your bladder expands to allow more fluid in. The average bladder capacity for an adult typically ranges from 400-600mL(3), (female bladders tend to be a bit smaller to spare room for the uterus).
As time goes by, urine begins to collect and the detrusor muscle starts to expand. And along with an expanding bladder comes…
… That Urgent Feeling
The urethra is the passageway from the bladder to the outside of the body. When the detrusor muscle in the bladder expands to a certain point, signals are sent to the sacral section of your nervous system to relax your bladder’s internal sphincter, allowing urine to begin to travel through the urethra.
This is an involuntary process - this is when you begin to realize you need to use the restroom.
Controlling the bladder’s external sphincter, the final passageway to exit the urethra, is a voluntary process - it is controlled directly by you.
You‘re probably familiar with how to stop urination mid-flow - this is you flexing your external urethral sphincter, willing it to contract.
And the pontine micturition center, located in the pons, is the portion the brain that allows you to control whether or not to urinate with your thoughts.
Living With the Condition
There are three different categories of bladder incontinence; each stemming from different causes, each posing different challenges.
1. Urge Incontinence
Urge Incontinence is the sudden urge to urinate (often referred to as overactive bladder). An uninhibited detrusor muscle will unpredictably expand and contract which causes the feeling of a full bladder, often followed by unexpected leakage.
Often the root of urge incontinence cannot be verified. Known causes of urge incontinence include(4):
- Multiple sclerosis
- Parkinson’s Disease
- A damaged spinal cord or an otherwise irritated nerve.
The elderly, the obese, men who have had prostate complications and women who have undergone a C-section surgery are all at a greater risk for urge incontinence(4).
Caring For Urge Incontinence
The goal should be to diminish detrusor muscle activity, but there are a few different behavioral methods in dealing with urge incontinence to curb the symptoms.
- An exercise that works your bladder’s external sphincter, called kegels, strengthens these muscles and can result in preventing leaks.
- To do kegels, as mentioned before, simply try to mimic the action of stopping urination in midstream, (but not when you are actually urinating).
- A strengthened external urethral sphincter will help make it easier to “hold it” when nature calls.
- Another method of regulating urge incontinence is what is referred to as “bladder training.”
- To do this, WebMD(5) suggests you train yourself to increase the time in between trips to the bathroom.
- Instead of going to the bathroom every half hour, train yourself to extend that frequency to every 45 minutes, then every hour, and so on.
2. Stress Incontinence
Stress Incontinence is the most common form of urinary incontinence
The cause of stress incontinence is through abdominal pressure that stresses the bladder and the urethral sphincters, allowing urine to leak. Any level of exertion can cause one of these leaks: coughing, sneezing, and laughing are simple actions that strain the abs and the bladder.
"Stress incontinence is related to the strength of the pelvic floor muscles," - Beverly Whipple, PhD, RN, professor emerita at Rutgers(6).
Pelvic surgery, for example, can adversely affect the muscles in this area.
Your bladder could be receiving abnormal pressure if the weakened muscles are not able to properly hold your bladder in place - your bladder cannot work well if the organ is not held in the intended physical location in which it was designed to function.
Stress incontinence is more common during, and in the aftermath of pregnancies - especially for those who have had multiple births. As you can imagine, a child in the womb would put massive pressure on the bladder. And the act of childbirth can damage the muscles along the pelvic floor to cause stress incontinence after the pregnancy.
Caring For Stress Incontinence
Again, as with urge incontinence, kegel exercises and training yourself to extend the times in between urination are possible methods of regulating the problem. Here are other ways to deal with stress incontinence:
- One way doctors help with stress incontinence, specifically in women, is with the use of a device called a pessary, which is set in the vagina to keep the urethra in place. But this can lead to hygiene problems and infections(7).
- Bulking agents such as collagen can be injected into the urethral lining for lengthening the urinary path (if you’re not afraid of needles down there). But this is usually a temporary solution, and the patient may need to receive frequent shots.
- Surgeries for stress incontinence include a sling procedure, which places a sling around the urethra or bladder and attaches it to the pubic bone.
- Retropubic suspension is another surgery that involves stitching the bladder to the pubic bone.
- And an artificial sphincter can be surgically implanted, which allows the patient to control the urethra manually.
3. Overflow Incontinence
Overflow incontinence is when the bladder has a hard time emptying, causing it to occasionally overflow.
This can be due to blockage of the urinary path (such as a urinary stone or an enlarged prostate), or from diminished detrusor muscle activity. Unsatisfying trips to the restroom are common for those with overflow incontinence(9).
The bladder will fill up to capacity and begin to overflow out of the urethra at unintended times. Trips to the bathroom could be impeded by hesitancy, meaning the flow of urination may take longer than usual to begin and may even come in intermittent streams - that is, if the trip to the bathroom is even productive in the first place.
Caring For Overflow Incontinence
Treatment for overflow incontinence includes clearing the urinary pathway through medications that relax the urethra, surgery, or urinary diversion through catheterization(10).
Now, there are two types of catheterization.
In the first, a small balloon filled with water is surgically fitted inside of the bladder to keep the catheter in place. And to use the catheter, a tube is inserted directly into the urethra. This is known as a Foley Catheter.
The second, known as a suprapubic catheter, involves inserting the catheter tube through an incision made in the abdomen that leads directly into the bladder(11).
If surgery, hard medications, and (especially) catheterization gives you the willies, there are more natural avenues to wellness...
Here’s a list of commonly used herbal medicines that have been studied and utilized for bladder/urinary complications. Keep your eye out for products containing these:
Corn silk is a substance that has been historically used for helping against kidney stones. More recent studies have shown that corn silk possesses anti-inflammatory properties as well(12).
Buchu is a South African plant used as an herbal remedy since 1650 for its antispasmodic and antipyretic qualities, as a cough remedy, and to fight colds and influenza. And although more research is required to determine the effects of Buchu for overactive bladder, it has been used as a diuretic and for kidney and urinary tract infection assistance(13).
Horsetail has shown through studies that it can be used as a diuretic due to its high concentrations of flavonoids, phenolic compounds, and mineral salts(14).
Ganoderma lucidum is historically used in East Asia for hepatitis, hypertension, hypercholesterolemia, and various cancers. Studies have also shown this plant to have a positive effect on those with prostate complications(15).
Pumpkin Seed has been traditionally utilized to combat nocturia (a condition in which the patient’s sleep is interrupted by frequent urges to urinate). Patients who received a pumpkin seed oil extract showed dramatic improvements in urinary frequency and urgency. These tests suggest that it is possible for pumpkin seed to help with overactive bladder(16).
Goldenrod has been a centuries-old aid for urinary tract infections. Goldenrod has also been tested for its anti-inflammatory, antimicrobial, and diuretic effects, and for helping against the formation of kidney stones(17).
Herbal medications are typically cheap and risk-free. Natural remedies coupled with bladder training exercises is a good place to start in finding the relief and freedom you’re looking for.
There are several options to choose from to find wellness and everyone's body is different - some things may help some people but not others.
Make sure you find the RIGHT solution for YOU. If your current plan of dealing with your bladder control issues isn't working, it's time to make a change or your problems will continue...
Don’t let bladder issues control your life - control your bladder issues.
***This article is intended to provide information and general education only - please don’t use this information to diagnose, treat, or cure any illness or medical condition, or as a substitute for medical advice.***
See you next time!
To your health,
-Chris Ford - Director of Health Research