you have to go and you can’t get to the bath- room in time, so some urine leaks out. This isn’t due to weak muscles, but to the bladder contracting at inappropriate times. “It’s really as if the bladder has a mind of its own,” says Cannon-Smith. The exact cause is unknown, but common risk factors include aging, uri- nary tract infections and neurological dis- eases, such as diabetes, Parkinson’s, stroke, multiple sclerosis and spinal cord injury. health for your
Why we need to talk about
light bladder leakage
By Angela Pirisi
HERE’S A QUICK health survey: Do you ever
suffer from heartburn? Dandruff? How about
light bladder leakage? Chances are that most
people wouldn’t want to answer that last question. Yet light bladder leakage is a lot more
common than people think—or care to admit.
More than 25 million Americans live
with urinary incontinence, and the majority
of cases (about 85 percent) occur in women.
“That’s because, physiologically, women
have many things happening, such as preg-
nancy and childbirth, which can cause the
pelvic floor to weaken and the bladder to
descend,” explains Nancy Muller, executive
director of the National Association for
Continence (NAFC). “But a wide variety of
people, men and women of all ages, have
bladder leakage problems.”
The number of people suffering from
bladder leakage is probably higher than
reported, however, since not everyone wants
to talk about it, suggests Dr. Tracy Cannon-
Smith, a urologist in Arlington, Texas. “We
see only a portion of people who seek treat-
ment for the problem. But some are embar-
rassed and don’t want to talk to their doctor.
Others don’t realize that any treatments exist.
And some may think that bladder leakage is
a natural process that just happens with age.”
So let’s start talking more about the prob-
lem now. There are two forms of urinary
incontinence: stress incontinence and urge
incontinence (also called overactive bladder).
Men suffer too
Figures suggest that 2 to 15 percent of
men between the ages of 15 to 64 and 5 to 15
percent of men over the age of 60 suffer from
some degree of bladder leakage. Men typically
suffer only from urge incontinence. Aging
and an enlarged prostate (which obstructs
and places undue pressure on the urethra) are
to blame. Stress incontinence occurs only in
men who have had prostate removal surgery.
Age itself doesn’t make incontinence
inevitable, but it can make symptoms grow
worse. “Things go on physiologically with age,
such as losing 2 percent of lean muscle mass
each year after age 20; we lose internal muscle
mass as well,” explains Muller. “We also don’t
empty our bladder as efficiently.” By age 80,
Muller says, men are just as likely as women to
experience an overactive bladder.
Where to get help
THE FOLLOWING resources offer a wealth
of information and advice about controlling
incontinence for both women and men.
American Urogynecologic Society
American Urological Association
National Association for Continence
The Simon Foundation for Continence
Treatments are available
According to NAFC, about 80 percent of
cases can be effectively treated. Lifestyle
changes such as diet and exercise can help.
Cannon-Smith says many people don’t realize
that what they eat and drink, such as alcohol,
caffeine and acid (such as in fruit juice), can
affect bladder health. Studies show that losing
weight can help stress incontinence too.
“People should know that we have many
simple treatments for these problems,” says
Cannon-Smith. Pelvic-floor rehabilitation
(strengthening through Kegel exercises) and
Two types, many factors
“Stress incontinence is a mechanical
problem—it’s just about weak muscles in the
pelvic floor,” explains Cannon-Smith. “So
when you cough, sneeze, lift something or
exercise, the muscles aren’t strong enough to
keep the urine from leaking.” The main
causes of this weakness are vaginal childbirth,
prolapse and aging. Anything that increases
pressure in the abdomen can trigger leakage,
such as walking, sneezing, laughing or jumping, says Cannon-Smith. Another, increasingly common cause is obesity, which also
puts extra pressure on the bladder.
Urge incontinence is when you feel like
bladder retraining (scheduled toileting to
delay voiding) can decrease both stress and
urge incontinence. Doing Kegels after child-
birth can strengthen the pelvic floor in
women. Some research shows that men might
benefit from Kegels after prostate surgery.
The Costco Connection
Costco and Costco.com carry Depend and
Poise pads to help people with incontinence.
Angela Pirisi is a Hamilton, Ontario–
AUGUST 2012 ;e Costco Connection 61