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 Become a Mask Wearer

Long before COVID-19, online chat groups for people with pulmonary fibrosis (PF) were filled with posts about how uncomfortable it is to wear a mask in public: not physically uncomfortable, a fact that was barely mentioned, but psychologically uncomfortable. For people with this condition or the lung transplant used to cure it, catching a cold or the flu could be deadly. They need to wear masks in public to help protect themselves from getting ill.

The participants discussed how awkward it is riding the bus in a mask, going to the grocery store in a mask, or boarding a plane while wearing one. They were mostly self-conscious that others would think they were ill or weak. Many would rather suffer the risk of getting fatally sick than put a mask on in a department store.

Now, we've all been directed to wear masks in public. Both Bennington and Wilmington's Select Boards have passed local mandates requiring masks in public places. This—along with distancing and handwashing—are crucial parts of returning to a more normal way of life. Suddenly, we are all feeling the psychological discomfort PF patients have felt for many years.

People usually have an interest in blending in. And, just like doing anything out of the ordinary, wearing a mask for the first time definitely feels like putting yourself out there. If we want to return to a somewhat normal way of life, masks are crucially important, along with frequent, thorough handwashing and keeping a distance from others.

Here are a few tips for making the leap from being someone nervous about wearing a mask to being a person who wears one regularly.

Do it for others. We know that people can spread COVID-19 as many as a few days before they get sick. Even if you feel fine, you could have COVID-19 right now without knowing it. At the same time, masks are far better at keeping sick people from spreading germs than they are at keeping people from getting sick. So wearing a mask isn't a sign of weakness; it's a sign of altruism. It's like saying, "I am not certain that I am not sick, so I want to pay those around me the consideration of limiting the likelihood I will infect them." Think of it as a badge of kindness.

Get a mask that fits. We know that masks are not completely comfortable physically. Getting the right fit makes a big difference in their "wearability." Cloth masks are readily available online and from local groups. The Green Mountain Mask Makers have excellent information and resources. If you can, purchase a few types in a few sizes to see which you like best. Buy enough of that type to allow washing between trips out in public.

Get a mask that you like. Once you have found a mask source and as long as you have a choice, pick one that you like. You can choose colors that match your wardrobe or that represent your interests, like camouflage. There are even masks that look like fashionable scarves when they hang around your neck. The sooner we start thinking of masks as part of our outfits, as essential and unremarkable as shoes or a belt, the healthier we will all be.

Try to quit caring about what others think. This one is hard. But one wise PF patient wrote, "I just don't give a darn!" Essentially, he shared that if people want to judge him for wearing a mask, so be it. Their opinions don't have a single thing to do with him. Many in the chat group applauded his confidence and vowed to adopt his attitude.

If we all do our best, soon the cultural scale will tip. Wearing a mask or not wearing one will cease to be a political statement. It will be normal. And thankfully, if wearing a mask in public, handwashing and sanitizing, and keeping our distance are all normal, going out into public again can be safe and normal too.

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

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