Taking Control of a Leaky Bladder
Courtney Carter
/ Categories: WELLNESS, 2024

Taking Control of a Leaky Bladder

Stress urinary incontinence (SUI), or the leakage of urine from the bladder, is a very common and frequently underreported problem affecting mostly women. It’s estimated that 38-55% of all women experience SUI at some point in their lives.

Caused by a weakening of the muscles in the pelvic floor, which prevent the bladder from holding in urinary whenever pressure is increased on the organ, the chances of experiencing SUI increases as person ages. Regardless of age, a person with SUI may may experience leakage when they:   

  • laugh

  • cough

  • sneeze

  • exercise

  • lift a heavy object

  • stand from a seated position

While anyone can develop SUI, there are factors that put you at greater risk. These include:

  • childbirth, especially vaginal birth

  • obesity

  • menopause

  • diabetes

  • uterine prolapse

  • surgery for prostate cancer or enlargement

  • pelvic surgery, including hysterectomy


Even though SUI is very common, it is not a normal part of aging and, more importantly, it can get better with appropriate treatment.

 Depending upon the severity of SUI, treatments can range from lifestyle changes to surgical. Common first-line treatments includes:

Weight loss: Studies have found that individuals with obesity who lose 5-10% of their body weight can achieve a 70% reduction in SUI symptoms

Pelvic floor exercises: Often referred to as Kegels, pelvic floor exercises strengthen the muscles that support your bladder and urinary system, and can significantly reduce—and in some cases—or eliminate symptoms of SUI.

Managing fluid intake and bathroom breaks: Keeping fluid intake at or under 64 ounces  per day—provided you’re not exercising or feeling thirsty—and taking regular bathroom breaks—every two hours—can help reduce symptoms of SUI.

Dietary changes: Certain foods and fluids are known to stimulate the bladder and may contribute to SUI. The following foods and drinks should be avoided:

  • caffeinate, this includes drinks like coffee, tea, energy drinks, and some 

  • acidic juices, especially orange, grapefruit, and tomato 

  • alcohol in any form

  • carbonated beverages, sodas, or seltzers, especially those with artificial sweeteners 

Prosthetic device: Commonly made of a soft silicone, a pessary is a device that fits the vagina to support the bladder. Patients must be fitted for a pessary. A properly fitted device can be worn for days or even months.

If those measures don’t work, surgical options may be considered.

Common SUI-corrective procedures include a midurethral sling and urethral bulking options are both highly effective, minimally invasive, and can be performed without an overnight stay at the hospital.

Living with stress incontinence can be challenging. However, you don’t need to suffer in silence or embarrassment. If you’re experience symptoms of SUI, schedule an appointment with a urologist to discuss how you can regain control of your bladder and your life.

 

Anthony Donaldson, MD, is a board-certified urologist at Southwestern Vermont Medical Center

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Cautious Entertaining

After almost 3 months of staying home and with the weather getting nicer, many of us are itching to invite friends over and catch up. While this is a natural inclination, it should be approached with significant caution. COVID-19 is still circulating. If you are planning to host, follow these helpful tips for a safe gathering at your home.

Keep the numbers small. Invite as few people as possible. One-on-one meetings are safer than group gatherings. The recommendations from Vermont Governor Phil Scott recommend 25 or fewer. I would still aim for fewer than 10, especially depending on the size of your entertaining space.

Choose invitees carefully. You should know almost everything about the socializing habits of the people you are inviting. Your guests should be as careful in their social interactions as you are in yours. You should also trust that your guests would be cancel if they were feeling ill, as should you if you are suddenly symptomatic. Those at high risk, due to age or a medical condition, should be very careful about hosting or accepting invitations.

Stay outside. Outdoor air movement disperses aerosolized particles more readily than indoor environments. And plenty of space outside allows guests to stay distanced. UV light, like the rays found in sunshine, may also provide some small benefit. It has been shown to decrease the viability of the virus on objects, but it is not yet clear how intense the light must be and for how long the object needs to be exposed in order to kill the virus.

Keep it short. Duration of exposure to others has been identified as a key risk factor. The longer you are near someone shedding the virus, even if they don't have symptoms, the greater your likelihood of catching it yourself. While it is awkward to say that you are inviting people over for a 10-minute chat in the driveway, this is certainly among the lowest-risk types of socializing.

Clean beforehand. If you expect guests to touch anything, the arms of patio chairs, for instance, wipe them down in advance. Ask everyone to sanitize or wash their hands as they arrive, if they touch their face, and about every hour or so.

Stay distanced and masked. People standing tend to drift. Place chairs 6 feet apart so that people will be more likely to stay apart. Unless you are eating, keep your masks on. Share this expectation in advance, so your guests bring their masks with them.

Limit contact points. If you are preparing food, be sure to wash well before cooking and ensure everyone has a portion of his or her own. Forget about platters of vegetables or bowls of chips everyone shares and even buffets, where people share spoons and tongs.

Clean after. Wipe down anything your guests may have touched after they leave.

Keep track. Be sure to take note of who was there, the date of the social event, and each guest's contact details. If any one of the attendees becomes ill with COVID-19 or learns that they may have been exposed at the time of the event, they will be able to reach out directly to the others and to share information readily with contact tracers.

With these tips, you can host a relatively safe get-together and relieve some of the social isolation of the past several weeks. Do know, however, that no party—regardless of how careful—is risk free. Weigh the risks, decrease those you can, and then, try to have fun.

Donna Barron, RN, is the infection preventionist at Southwestern Vermont Medical Center.

 

 

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