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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How to Maintain a Healthy Immune System

There are so many things that we have little control over. We can't control what genes we get, how old we are, or what viruses are circulating in our environment, but there is a lot we can do to prevent illness. Remarkably, many of the same habits that protect you from diseases like diabetes, cancer, and heart disease also help your immune system fight infections.

Most viruses can't hurt you until they get inside your body. So, we can help our immune system if we avoid viruses and cut off the ways they travel. Viruses can spread through the air, but not usually for very far. Keep your distance—at least 6 feet—from others, and be a good neighbor by wearing a mask in all public areas.

Viruses that cause the most common illnesses—respiratory infections, including the common cold, flu, and the new COVID-19—travel into the body through your mouth, nose, and eyes and make their way to the areas they infect, like the lungs. The best way to break this chain is to clean your hands frequently, and don't touch your face with hands that have touched anything else. In addition, you can reduce the number of viruses in your environment by cleaning frequently touched objects with a bleach- or alcohol-based cleaner.

Vaccinations are your next line of defense. Immunizations, like the flu shot, introduce a small and harmless part of a virus or bacteria. The vaccine gives your immune system an opportunity to make antibodies against the virus. A vaccinated immune system responds more quickly and effectively when illnesses are introduced. What's more, when we all get vaccinated, we decrease the likelihood that anyone will get sick. If you are unsure about whether you or your children are up to date on their vaccinations, call your primary care provider’s office.

Your third line of defense is living a healthy lifestyle. It is clear that the same things that help the rest of our bodies function also improve the strength of our immune response. Likewise, things that hinder our bodies' ability to function compromise the immune system.

Regular exercise might be the most powerful way to maintain a healthy immune system. By increasing heart rate and blood flow, we allow the cells and substances of the immune system to move through the body freely and do their job efficiently. Similarly, things that slow the movement of cells and substances, like smoking or drinking alcohol in excess, may decrease the body’s ability to function and decreases the immune response, as well.

Getting adequate sleep may also positively affect the immune response. Chronic sleep deprivation has been shown to decrease the beneficial boost in immunity from vaccinations.

Our emotional state, too—whether we are stressed, lonely, or depressed, for instance—affects our immune response so much that a relatively new specialty called psychoneuroimmunology now studies the connection. One pioneering study, conducted in the early 1980s, found that college students operating within a stressful 3-day exam period had fewer of the cells that fight tumors and viral infections. In simple terms, the students almost stopped producing immunity boosters and infection fighters.

Finally, physicians have concluded that eating a mostly plant-based diet—including fruits, vegetables, beans, nuts, whole grains, and lean protein—supports overall health and may also support immunity. Nutritious foods include important vitamins that the immune system needs to function, such as beta carotene, vitamin C, vitamin D, and zinc. Note, however, that supplements that claim to improve immune function have not yet been shown to do so to the extent necessary to protect against infection and disease. It is better to eat whole foods that are rich in vitamins rather than take supplements.

Always consult with your provider before making changes to your exercise plan or trying a new supplement and if you have any medical concerns. Physicians and the other professionals working in their offices also provide help for developing a plan for a healthier life. Call your primary care office or 802-447-5007 to find a primary care provider.

Healthy habits, like those that protect your body from disease and infection, are not always easy to adopt or maintain. Perhaps knowing just how important they are to maintaining a healthy immune response will provide the extra motivation necessary to make them a priority.

Kim Fodor, MD, is an internal medicine physician at SVMC Internal Medicine.

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