How Do You Know If Your Bladder Is Falling – Stress urinary incontinence (SUI) occurs when urine leaks out and the bladder and urethra are suddenly squeezed, causing the muscles to stretch for a short period of time. With mild SUI, stress can be from sudden movements, such as exercise, depression, laughter, or coughing. If your SUI is more severe, you may leak with vigorous activities such as standing, walking, or bending over. Urine “accident” like this can be enough to wet your clothes from a few drops of urine.
A common bladder problem is called overactive bladder (OAB) or acute urinary incontinence (UUI). People with OAB have a sense of uncontrollable nervousness, a sense of “climbing”. Some people with OAB experience urinary leakage when they feel the urge. The difference between SUI and OAB is anatomical. SUI is a urinary tract problem, while OAB is a bladder problem. With SUI, the urinary tract cannot stop the sudden increase in pressure. With OAB, the bladder is tight and has incontinence. To learn more about the OAB, visit our OAB website.
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Many people with SUI also have OAB. When both types of urinary incontinence occur, it is called “mixed incontinence.”
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About 1 in 3 women will experience SUI at some point in their lives. Urinary tract infections increase with age. More than half of women with SUI have OAB.
Men who leak urine have an overactive bladder (OAB). For men with SUI, it may be due to prostate cancer surgery, pelvic trauma or injury.
The urinary system includes the two kidneys, two ureters, the bladder, the urethra and the ureter. The bladder is held in place by the pelvic fascia. These systems work together to store and remove waste from our body, especially urine.
The main symptom of SUI is urination during any activity that increases abdominal pressure. The amount can be a teaspoon or more. If you have mild SUI, you will leak during vigorous activities such as exercise. It can leak when you sneeze, laugh, cough, or lift something heavy. If your SUI is moderate or severe, you may leak when you do strenuous activities such as standing or bending over.
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These symptoms are different from dyspepsia or overactive bladder (OAB). With OAB, you experience urinary urgency and incontinence. These “serious” feelings can happen often. The discharge includes large amounts of urine. For more information about the OAB, visit our OAB website.
Many people find that SUI interferes with daily and social activities. It affects family and sexual relationships. Some people even start to feel alone and hopeless because of this.
You may be embarrassed by this problem. You may not want to talk to your loved ones or even your doctor about it. Find out if a primary care doctor or specialist can help.
If you answered yes to any of these questions, you should know that things are about to change for the better. There are many ways to manage and treat SUI.
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The pelvis supports the bladder and urinary tract. If this area is stretched, weakened or damaged, then SUI can occur. Pregnancy and childbirth can cause this. A chronic cough or lower back or pelvic surgery that cools the nerves (such as prostate cancer surgery) can weaken the muscles.
SUI affects older women more often, however, not just because of old age or being a woman. It also happens in young women and some men. For some young women, it starts with labor and then gets better.
The first step in diagnosing SUI is to discuss your symptoms with your healthcare provider. If you think you have SUI, tell your provider what happened. This is the only way to know for sure and mitigate. Start with a primary care provider who can start treatment without referring you to a specialist. If necessary, they can refer you to a urologist or gynecologist. These are doctors with more experience in pelvic conditions such as urinary tract infections. Some may have additional certification in Female Pelvic and Reconstructive Surgery (FPMRS).
If you don’t feel comfortable talking about your symptoms, a little planning can give you more confidence. Here are a few ways to help start a conversation with your provider about getting help:
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Write down your experiences and questions before your visit and bring this with you. Your notes help you remember what you want to say. Make a list:
If your health care provider doesn’t ask you about SUI symptoms, bring up the subject. Don’t wait until the end of your visit. Talk about it early. Then there will be time for questions. If the nurse sees you first, tell the nurse about your symptoms.
Talk to your health care provider about your symptoms and feelings. Talk about how it affects your life. Your provider is used to hearing all kinds of problems. It is good to speak freely.
When you talk to someone who can address your concerns, it helps to write down what you want to ask in advance. Bring your list to your visit. You may also consider starting a bladder diary. A bladder diary is a tool for tracking urination patterns. That way, you can see what problems you are having with urination and discharge, and your eating/drinking patterns for a few days. Keep your diary with you. You and your healthcare provider will get through it together.
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Next, your health care provider will begin an evaluation to find out what is causing the problem. Here are some things that health care providers can do to find the cause of SUI:
Your healthcare provider will ask about your symptoms, how long you’ve had them, and how they’re affecting you. The medical history includes questions such as:
Your healthcare provider can help you, so don’t be embarrassed to talk about this topic. Be honest. This information will guide you in the best way to deal with your problem.
For women, your physical exam may include an examination of your abdomen, pelvic organs, and rectum. For men, a physical examination includes an examination of the genitals and the abdomen, prostate, and rectum. Your health care provider may also test how strong your pelvic floor muscles and spine muscles are. You may be asked to contract your pelvic floor muscles and back muscles for a Kegel test.
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Your doctor may ask you to make movements such as coughing, straining, or throwing up that make you urinate.
It is a good idea to start and keep a “bladder diary.” This is a tool to track your daily symptoms. Keep a diary of what liquids you drink and how often you go to the bathroom. You should pay attention to leaks. Include what you are doing when you are exposed to things like a runny nose, cough, or sneeze.
The symptoms you share can help your provider understand what’s going on so they can begin to diagnose and treat you.
There are two types of urine tests: one-hour tests and 24-hour tests. A one-hour board test usually involves learning to go through an exercise or movement in the office. The pore is removed and then weighed to assess the amount of urine. A 24-hour urinalysis is usually done at home for round-the-clock evaluation.
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Sometimes symptoms and physical examination do not provide enough information to make an accurate diagnosis. If this is the case, you may be referred to a specialist for more comprehensive tests.
Once your provider understands the type of discomfort you have and rules out other conditions, he or she can recommend treatments to help you feel better.
You and your healthcare provider can talk about ways to treat or manage SUI symptoms. Your provider should explain the benefits and risks of each option and help you decide what is best for you. Remember that not every treatment is right for everyone, and you may need to try more than one.
There is currently no drug approved for the treatment of SUI in the United States. Sometimes, if you have SUI and OAB (mixed sclerosis), your healthcare provider may prescribe OAB medication to treat OAB. These medications can help reduce the leakage of an overactive bladder. They do not cure SUI.
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You may need to rely on absorbent pads daily or occasionally. A bandage is also used while you are waiting for surgery or recovering from surgery. Blotting paper comes in different sizes and styles. Some are just stickers on your underwear, some are messages in your pocket. These may work for you, or you may decide they are not controlling enough.
Kegel exercises help strengthen your pelvic floor muscles. You perform Kegels several times a day by contracting (squeezing) and relaxing your pelvic floor muscles. The pelvic floor muscles help support the bladder and other organs. Exercising these muscles will make them stronger and help reduce or eliminate your SUI symptoms. For maximum benefit, do these exercises daily.
Make sure you follow these exercises correctly
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