Thursday, September 14, 2023

Can Stress Cause Bladder Leakage

Botulinum Toxin A Injections

Stress Related Urinary Incontinence

Botulinum toxin A can be injected into the sides of your bladder to treat urge incontinence and overactive bladder syndrome .

This medication can sometimes help relieve these problems by relaxing your bladder. This effect can last for several months and the injections can be repeated if they help.

Although the symptoms of incontinence may improve after the injections, you may find it difficult to fully empty your bladder. If this happens, you will need to be taught how to insert a catheter into your urethra to drain the urine from your bladder.

Botulinum toxin A is not currently licensed to treat urge incontinence or OAB, so you should be made aware of any risks before deciding to have the treatment. The long-term effects of this treatment are not yet known.

Urinary Incontinence Is Emotionally Stressful Too

Women who suffer from incontinence may also suffer from anxiety and depression. Perhaps the association is simply due to embarrassment, isolation, or pulling back from social situations due to concerns about experiencing UI in the presence of other people. In any case, its fair to say that depression and anxiety can be complications of experiencing chronic urinary incontinence.

We understand your sensitivity about this subject. Weve helped many patients regain control to live a full, active life again a life that doesnt include always knowing where the closest bathroom is. Effective treatments for stress incontinence may include physical therapy, a change in lifestyle habits, or tension-free vaginal tape.

If you experience urinary incontinence when you cough, sneeze, or are physically active, make your appointment now so we can find out whats going and recommend the treatment option thats right for you. Use the online booking tool here on the website, or call our office in Princeton, West Virginia.

Diagnosis Screening And Prevention

The presenting symptom of urinary incontinence is, by itself, not necessarily diagnostic of the subtype of urinary incontinence or its underlying cause. A comprehensive assessment is needed to determine the exacerbating factors, the effect on the womans quality of life and her desire for treatment. The typical diagnostic work-up involves medical history, physical examination, urinalysis , assessment of post-void residual volume and exclusion of conditions that require specialist referral . After these assessments, a provisional diagnosis of stress, urgency or mixed urinary incontinence can be made in the majority of patients. Most women present with a degree of mixed urinary incontinence, and establishing the predominant symptom can assist in directing the appropriate treatment. Depending on the severity of the individual components of their overall incontinence, patients often benefit from initial treatment that is focused on urgency urinary incontinence.

Diagnostic work-up of women with urinary incontinence

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How Is Stress Incontinence Diagnosed

Your healthcare provider will perform a physical exam and ask about symptoms. You may need to keep a bladder diary for two to three days to monitor your fluid intake, bathroom use and urine leakage. Your notes should include what you were doing before the leakage. This information can help your provider make a diagnosis.

Tests for stress incontinence include:

  • Urinary pad test: You wear an absorbent pad for 24 hours at home. Your provider weighs the pad after use to determine the volume of leaked urine.
  • Urinalysis: This test checks for signs of infection in a urine sample. Urinalysis can help determine if you have a urinary tract infection or blood in your urine . These signs may indicate a different problem.
  • Bladder scan: A brief ultrasound in your healthcare providers office to make sure you are emptying your bladder when you pee.
  • Ultrasound: A pelvic or abdominal ultrasound assesses the health of the bladder, kidneys and other organs.
  • Cystoscopy: During a cystoscopy, your provider uses a scope to examine your urinary tract.
  • Urodynamic testing: This group of tests gauges how well your urinary system holds and releases urine. Urodynamic testing includes a postvoid residual urine test. The test measures how much urine is still in the bladder after you pee.

Is Stress Contributing To Your Incontinence

Stress urinary incontinence

As you may already know, incontinence is really common. Approximately 15 million American women deal with urinary incontinence. And about 24% of women over 40 have experienced fecal incontinence at least once in the past year, too.

But, just because incontinence is common doesnt take away the embarrassment. The sheer thought of an unexpected leak is stressful. Plus, research shows that stress and incontinence are closely intertwined. But do stress, anxiety, and other mental health issues cause incontinence? Or does incontinence negatively impact our mental health? With 1 in 5 American adults, or 43.8 million people, experiencing mental health issues every year, you just might want to stick around to find out.

Also Check: How Does Stress Make Your Hair Fall Out

What Causes Bladder Weakness

Bladder weakness usually occurs when the muscles in the pelvic floor or sphincter have been damaged or weakened.

Both men and women have a pelvic floor. It is made up of layers of muscles which hold the bladder and bowel in place and help to stop leaks. The sphincter is a circular muscle that goes around the urethra and squeezes as the bladder fills up to create a seal so that urine cant leak out.

In women, these muscles can be weakened during pregnancy by the extra weight and natural hormonal changes. Childbirth can cause more problems especially if delivery is prolonged or the baby is large. Forceps and ventouse assisted deliveries may increase the risk of damage, muscle tearing or episiotomies can cause further damage.

Some women develop stress urinary incontinence after the menopause. This is because the pelvic floor becomes weaker following hormone changes within the body. Even before the menopause, some women may notice that they have a weaker bladder than normal in the week before a period. Stress urinary incontinence may occur after a hysterectomy and also after operations on the bladder.

People who have been constipated for a long time or have a chronic cough may also be prone to stress urinary incontinence. Men can develop stress urinary incontinence if they are experiencing problems related to their prostate gland or post prostate surgery.

How Can A Hysterectomy Cause Urinary Incontinence

A hysterectomy, or removal of the uterus, may cause urinary incontinence.

There are a few reasons this might happen:

  • After the uterus is removed, the bladder may no longer hold as much urine.
  • Leakage of urine may be related to stress and urge incontinence like when you exercise or need to go to the bathroom.
  • The nerves that control bladder function may be damaged, which can cause problems with urination, including leakage.

If you have a hysterectomy, your bladder could become overactive because the muscles and ligaments that help hold in urine are weakened, damaged, or removed.

Are you experiencing urinary incontinence after a hysterectomy?

If so, ONDRwear can help.

There isn’t any definitive research on how hysterectomies can cause incontinence.

However, most theories are related to stress and urge incontinence.

Stress Incontinence

Stress incontinence happens because of pressure on the pelvic floor, causing loss of bladder control function.

If you have a hysterectomy, you may have trouble controlling your bladder because the …

  • Connective tissues
  • Lift something heavy
  • Urge Incontinence

    Urge incontinence is the sudden urge to urinate without being able to suppress it and hold it in.

    Similar to what is experienced with stress incontinence, the

    • Muscles
    • Ligaments

    … from the pelvic floor are weakened.

    Sometimes there even can be nerve damage to the bladder from hysterectomy because of its proximity to the uterus, which also affects bladder control.

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    What You Can Do

    Its easy for someone on the outside to say just dont worry, right? However, this is definitely one of those things thats easier said than done. If you have significant anxiety or depression, please give your doctor a call. For the more common daily stressors in all of our lives, there are things you can do to help you worry less and hopefully decrease leaks too.

    One option is to use absorbent products, so that the only person that knows you leaked is you. NAFC recently conducted a study that found that those who felt positively about wearing absorbent products said it was because it made them feel more protected and in control. And who doesnt want to feel more in control? Plus, Lily Bird can help take the stress out of going to the store by delivering pads and disposable underwear straight to your door.

    Dont forget about trying pilates to doing Kegels or making dietary changes to see if that helps with incontinence or stress, too. Whether your stress is a symptom or a cause, getting it under control can help no matter what situation youre in.

    ~Written by Lily Bird, a proud Trusted Partner of NAFC

    Sneezing Coughing Or Laughing

    Stop Stress Urinary Incontinence With 5 Easy Exercises

    In much the same way, sudden or dramatic body movements caused by coughing, sneezing, or a good belly laugh can also play a role in stress incontinence. Although these movements may seem subtle in comparison to moving a heavy object, the results may be the same when it comes to unintentional urine leakage.

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    What Are Kegel Exercises

    Kegel exercises, also called Kegels or pelvic floor muscle training, are exercises for your pelvic floor muscles to help prevent or reduce stress urinary incontinence. Your pelvic floor muscles support your uterus, bladder, small intestine, and rectum.

    Four in 10 women improved their symptoms after trying Kegels.9 Kegels can be done daily and may be especially helpful during pregnancy. They can help prevent the weakening of pelvic floor muscles, which often happens during pregnancy and childbirth. Your pelvic floor muscles may also weaken with age and less physical activity.

    Some women have urinary symptoms because the pelvic floor muscles are always tightened. In this situation, Kegel exercises will not help your urinary symptoms and may cause more problems. Talk to your doctor or nurse about your urinary symptoms before doing Kegel exercises.

    What Are The Treatments For Urinary Incontinence

    Treatment depends on the type and cause of your UI. You may need a combination of treatments. Your provider may first suggest self-care treatments, including:

    • Lifestyle changes to reduce leaks:
    • Drinking the right amount of liquid at the right time
    • Being physically active
    • Staying at a healthy weigh
    • Avoiding constipation
    • Not smoking
  • Bladder training. This involves urinating according to a schedule. Your provider makes a schedule from you, based on information from your bladder diary. After you adjust to the schedule, you gradually wait a little longer between trips to the bathroom. This can help stretch your bladder so it can hold more urine.
  • Doing exercises to strengthen your pelvic floor muscles. Strong pelvic floor muscles hold in urine better than weak muscles. The strengthening exercises are called Kegel exercises. They involve tightening and relaxing the muscles that control urine flow.
  • If these treatments do not work, your provider may suggest other options such as:

    • Medicines, which can be used to
    • Relax the bladder muscles, to help prevent bladder spasms
    • Block nerve signals that cause urinary frequency and urgency
    • In men, shrink the prostate and improve urine flow
  • Medical devices, including
  • A catheter, which is a tube to carry urine out of the body. You might use one a few times a day or all the time.
  • For women, a ring or a tampon-like device inserted into the vagina. The devices pushes up against your urethra to help decrease leaks.
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    Risk Factors For Urinary Incontinence

    Other conditions that can lead to incontinence in both males and females are:

    • Other medical conditions, such as diabetes
    • Neurological condition such as MS, spinal cord injuries, or Parkinsons disease
    • Being overweight
    • Obstructions along the urinary tract that block the flow of urine
    • Certain medications

    Who Is Most At Risk

    Managing vs. Treating Urinary Incontinence (UI)

    In addition to the causes mentioned above, there are some things that can increase your risk of developing urinary incontinence without directly being the cause of the problem. These are known as risk factors.

    Some of the main risk factors for urinary incontinence include:

    • family history there may be a genetic link to urinary incontinence, so you may be more at risk if other people in your family have experienced the problem
    • increasing age urinary incontinence becomes more common as you reach middle age and is particularly common in people over 80
    • having lower urinary tract symptoms a range of symptoms that affect the bladder and urethra

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    What Are The Symptoms Of Stress Incontinence

    The main symptom of stress incontinence is a leakage of urine at times of physical movement or activity. Examples of the kinds of activities associated with urine leaking include laughing, coughing, lifting, or exercise. The leakage may be as little as a drop or two, or may be a “squirt,” or even a stream of urine.

    Symptoms And Risk Factors

    A comprehensive patient history includes the onset, duration and timing of urinary incontinence, and associated LUTS and voiding symptoms , recognizing that the reported symptoms often relate to the patients normal bladder function and expectations. Other risk factors or conditions that can exacerbate urinary incontinence should also be assessed and include age, obstetric history , gynaecological status , medical status and pharmacological status . Patients with mild cognitive impairment are 30% more likely to have urinary incontinence. In addition, functional and lifestyle factors, such as smoking status, mobility and frequency of heavy lifting, should be considered during assessment.

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    Medications That Can Cause Urinary Incontinence

    Urinary , or the loss of bladder control, can be caused by various health conditions and physical changes, such as childbirth, changes in diet, infection, prostate issues, menopause, and neurological disorders. But there are also a number of medications can cause urinary incontinence in both men and women in a variety of different ways.


    Diuretics such as hydrochlorothiazide , furosemide , bumetanide , triamterene with hydrochlorothiazide

    Increase urine production by the kidney

    Frequent urination, overactive bladder, stress incontinence

    Muscle relaxants and sedatives such as diazepam , chlordiazepoxide , lorazepam

    Cause sedation or drowsiness relax the urethra

    Frequent urination, stress incontinence, lack of concern or desire to use the toilet

    Narcotics such as oxycodone , meperidine , morphine

    Cause sedation or drowsiness relax the bladder, causing it to retain urine

    Lack of concern or desire to use the toilet, difficulty in starting urinary stream, straining to void, voiding with a weak stream, leaking between urinations, frequency incontinence

    Antihistamines such as diphenhydramine and chlorpheniramine

    Relax the bladder, causing it to retain urine

    Overflow incontinence

    Alpha-adrenergic antagonists such as terazosin , doxazosin

    Relax the muscle at the outlet of the bladder

    Leaking when coughing, sneezing, laughing, exercising, etc.

    From , Harvard Health Publishing

    Image: Thinkstock

    Uncontrollable Urination: A Rare Anxiety Symptom

    Dr. Yaser Bassel Discusses Hyperactive Bladder and Stress Incontinence – BayCare Health System

    Many people struggle with feeling as though they need to urinate when they have anxiety. Luckily, even when this occurs, it is still controllable. It’s a standard part of anxiety and anxiety attacks.

    But when anxiety reaches its absolute peak, some people experience a loss of bladder control, also known as “incontinence.” It’s one of the most distressing and embarrassing anxiety symptoms, and if it ever happens to you, it becomes something you fear for possibly the rest of your life.

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    Medication For Stress Incontinence

    If stress incontinence does not significantly improve, surgery for urinary incontinence will often be recommended as the next step.

    However, if you are unsuitable for surgery or you want to avoid having an operation, you may benefit from a medication called duloxetine. This can help increase the muscle tone of the urethra, which should help keep it closed.

    You will need to take duloxetine by mouth twice a day and will be assessed after two to four weeks to see if the medicine is beneficial or if it is causing any side effects.

    Possible side effects of duloxetine can include:

    Do not suddenly stop taking duloxetine as this can also cause unpleasant effects. Your GP will reduce your dose gradually.

    Duloxetine is not suitable for everyone, however, so your GP will discuss any other medical conditions you have to determine if you can take it.

    Impact Of Urinary Incontinence

    Urinary incontinence is a largely undertreated condition. Despite the widespread prevalence of urinary incontinence, only a fraction of sufferers ever seek treatment.

    Issues like stigma and embarrassment keep many from reaching out for help. Yet, despite the unwillingness to talk about it, incontinence is something that greatly impacts the people it affects.

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    What Are The Risk Factors For Stress Incontinence

    Anyone can have urinary incontinence, but the problem affects twice as many people AFAB as people assigned male at birth . Its estimated half of women over age 65 have stress urinary incontinence. But urinary incontinence is not a normal part of aging. Its a sign of a problem that can get better with appropriate treatment.

    Risk factors for stress incontinence include:

    Things That Can Make Incontinence Worse

    Urinary Incontinence

    Incontinence can happen to anyone, although its more common in women than in men. Mild urinary leakage affects most women at some time in our lives, says Mary Rosser, MD, PhD, an assistant professor in obstetrics and gynecology at Montefiore Medical Center, in New York City. Although it is more common in older women, younger women may experience leakage as well. You may have stress incontinence, urge incontinence, or some other type.The good news is that there are treatmentsand lifestyle changesthat can help.

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