I’m sure you’re familiar with the phrase, “I’m gonna wet myself” when there’s a lot of laughter. But when it actually happens to you, you won’t find it so funny. It is not uncommon for younger women to notice when they laugh or sneeze, how they lose a few drops of urine. This can be caused by bladder weakness or – as the doctor says – urinary incontinence. Whatever it’s called, you probably feel terribly embarrassed. It doesn’t have to be embarrassing.
This is not a problem for older ladies. Although the risk of bladder weakness increases with age, young women are also affected. About 25 per cent of all women between 25 and 35 years of age experience temporary bladder weakness, for example as a result of childbirth. A total of around 10 million people in Germany suffer from incontinence.
But a few drops of urine when you sneeze or laugh – does that mean you already suffer from bladder weakness? Yep. According to the International Continent Society (ICS ), any form of involuntary loss of urine is initially an incontinence. However, urologist Prof. Dr. Ricarda M. Bauer from Munich gives the all-clear: “This is very individual, it is a matter of how much urine loss affects your quality of life. It is important not to suffer quietly.
Our expert gives tips on what you can actively do against incontinence and answers these questions:
- What forms of incontinence are there?
- What are the causes of incontinence?
- Can I prevent incontinence?
- How is incontinence treated?
- What home remedies are available for bladder weakness?
To exercise your bladder, you should not go to the toilet at the first urge to urinate. © Pair Srinrat / Shutterstock.com
What forms of incontinence are there?
In incontinence, medicine distinguishes between four main forms:
- Stress incontinence
A major form of incontinence is stress incontinence, also called stress incontinence. “However, I find the term stress incontinence misleading. Many associate it with psychotic women who lose urine under stress,” says the urologist. In reality, however, this term refers to an increase in pressure in the abdominal cavity, for example due to a severe cough or sneeze. This leads to the patient losing urine.
- Urge Incontinence
This form, in turn, is actually partly stress-dependent and refers to an excessive urge to urinate that suddenly appears out of nowhere. In other words: If you don’t find a toilet quickly enough, you may lose urine uncontrollably.
- Mixed incontinence
This is a mixture of urge incontinence and stress incontinence.
- Overflow incontinence
This is a very rare special form, which also usually affects men with an oversized prostate. For various reasons, they can no longer empty their bladder as usual. The urine spills over like water from a full sink.
What to do with genital herpes?
What causes bladder weakness?
Everything that means pressure and expansion for the pelvic floor can Stress incontinence in women. These include pregnancies, births, obesity, chronic coughing or hormonal influences that lead to tissue changes.
Lowering of the bladder, uterus or intestine also has a negative effect on the pelvic floor and thus on the sphincter muscle. Operations of the urethra and the sphincter muscle can also be responsible for incontinence. However, this is an absolute exception.
Aging processes of the bladder and brain are decisive factors for Urge Incontinence . Neurological diseases such as Parkinson’s and Alzheimer’s can also play a role.
Hormonal changes also have a major influence on the bladder. In addition, the metabolic syndrome, i.e. the coincidence of several risk factors for cardiovascular disease and diabetes, gynaecological problems and intestinal surgery can be responsible for bladder weakness. An overactive bladder is also conducive to incontinence.
Incidentally, men have an advantage with regard to incontinence, as there is a kind of plug in the male urethra which closes it. This device does not have the female urethra. That’s not fair.
Some foods can promote bladder weakness, such as coffee and grapefruit. © Chiociolla / Shutterstock.com
How does incontinence start?
Unless you become incontinent after surgery or an accident, bladder weakness is a gradual process. Most people lose a drop of urine every now and then when they sneeze or cough. As you get older, it gets worse and you lose urine when you laugh or exercise. The same applies to a hyperactive bladder. “At first, once a month patients can’t make it to the toilet. Over time, patients may not make it to the toilet quickly enough several times a day,” says Professor Bauer.
Can I prevent incontinence?
The good news is that there is a lot you can do yourself to prevent or limit incontinence in advance.
- Avoid overweight: “The be-all and end-all for preventing incontinence is to avoid being overweight,” the expert stresses. There are studies that prove that you can significantly reduce both stress and urge incontinence by losing 5 percent of your weight. Provided, of course, that you are overweight.
- Exercise pelvic floor: Any stress on the pelvic floor increases the risk of incontinence. For example, women who engage in extreme sports such as weightlifting belong to the risk group. But: If you like to do knee bends or cross-lifting in the gym with dumbbells, you should continue with confidence. After all, a sporty and active lifestyle is essential for the targeted prevention of bladder weakness.
Above all, you should train your pelvic floor. Women who have just given birth should in any case do regression gymnastics. The professor of urology also recommends pelvic floor training for older women. In addition, the expert advises Pilates exercises, as these also specifically strengthen the pelvic floor. Ask for courses at the adult education centre or fitness studio!
- Give up smoking: A healthy lifestyle has a strong influence on urge incontinence. This includes stopping smoking, as nicotine is an irritant that particularly irritates your bladder.
- Eat healthy: Another risk factor is chronic constipation, i.e. constipation. Due to the pressing during bowel movement, an enormous pressure is exerted on the pelvic floor. Therefore, you should eat a healthy and fibre-rich diet.
To train your pelvic floor
How is incontinence treated?
To treat bladder weakness, the best method is to combine physiotherapy with pelvic floor exercises. “You can achieve particularly good results by training your pelvic floor with electrostimulation and biofeedback,” says urologist Bauer. “With both methods, you insert a vaginal probe into the vagina like a tampon. This probe is connected to a measuring device by a cable.”
There are two ways to adjust the device:
- At Biofeedback actively tense your pelvic floor muscles and can check visually on the measuring device whether you are doing the training correctly. This gives you feedback on whether you are tensing your pelvic floor sufficiently and long enough.
- At the Electrostimulation your pelvic floor is passively stimulated by electrical impulses when the device is switched on in order to strengthen the muscles.
Sometimes the problem is an urgent need, but often it is only a few unwanted drops. © Kaspars Grinvalds / Shutterstock.com
At what point is it worth Blasen-OP ?
Only if the mentioned treatment methods remain unsuccessful, you should think about an operation. The main method is the TVT -(tension-free vaginal tape), in which a small plastic band is placed in front of the urethra under local anaesthetic to stabilise it. The closing mechanism then does not immediately give way under load.
However, this procedure is only performed on women over 35 to 40 years of age who do not wish to have children because the band could slip during childbirth. Anyone who has been treated with a TVT is cured in 85 percent of cases and usually has no problems with it even after 5 years. In another 10 percent there is at least an improvement in incontinence.
What home remedies help with bladder weakness?
For stress incontinence, vaginal tampons and pelvic floor exercises help. You should do these exercises for 10 minutes every day if possible. However, patience and perseverance are required: the success of pelvic floor exercises only sets in after 3 to 6 months.
For urge incontinence, over-the-counter drugs are available at the pharmacy. But: “For these drugs no guideline recommendation can be given. Studies that are supposed to prove that these drugs are helpful are not particularly high-quality. I recommend bladder retraining, particularly in the early stages,” emphasises the urologist. Here’s how it goes’s: Don’t go to the toilet immediately every time you have an urge to urinate. Stay calm and remember that your bladder is not really full.
Tip: Combine bladder retraining with pelvic floor exercises.
Anyone who suffers from a frequent urge to urinate should exercise the pelvic floor daily, for example by lifting their hips. © mangostar / Shutterstock.com
Are there any foods or drinks I should avoid?
Above all, you should avoid irritants such as nicotine, caffeine or hot spices. Important: Caffeine in particular has a very negative influence on your bladder muscles. Over 500 ml of coffee per day increases your risk of incontinence by 25 percent. Ergo: If you have problems with your bladder, you should avoid coffee if possible.
In addition, the expert recommends keeping a bladder diary to find out which drinks and snacks you react to with an increased urge to urinate. Prof.
Bauer: “In many patients, the symptoms are made worse by acidic drinks such as grapefruit. Some people also react sensitively to light drinks.”
How to treat a bladder infection correctly
What kind of bandages are available for bladder weakness?
Important: Only use products specifically designed for urinary incontinence. These contain a gel that absorbs fluid and ensures that no odour is produced. Some manufacturers’ sanitary towels contain a special fleece that absorbs the fluid. Do not use sanitary pads or panty liners! These work with completely different systems than incontinence pads.
Does bladder weakness have something to do with age?
Also. The older you get, the higher the risk of becoming incontinent. For women, the risk also increases during pregnancy and after giving birth. If you have a hormone deficiency due to the menopause, you can use estrogen preparations as ointment and vaginal suppositories. “40 percent of women over 60 have some form of urinary incontinence,” says the urologist.
Which doctor can help with bladder weakness?
Your first point of contact should be your family doctor or gynaecologist. If your doctor is not familiar with the subject, visit the website of the German Continence Society. Here you will find important information on counselling centres as well as gynaecologists and urologists who specialise in the topic.
Bladder weakness is nothing to be ashamed of. About 50% of all women have experience with involuntary urine leakage. The good news is that you can take active measures against incontinence. If bladder weakness becomes a problem for you, see a doctor. They can advise you on a range of treatments for your incontinence.