Bladder weakness (urinary incontinence) occurs in one in four women and one in eight men.
What is bladder weakness?
Bladder weakness (urinary incontinence) is involuntary loss of urine. It occurs in one in four women and one in eight men, making it as common as hay fever.
How the bladder works
The bladder produces 1.5 litres of urine in a 24-hour period and is emptied 4-8 times during that time. An average person’s bladder can hold 350 to 550 millilitres (ml) of urine and most people feel the urge to urinate when there is approximately 200 ml of urine in the bladder.
The nervous system tells you when you need to urinate and it allows your bladder to keep filling. During the emptying phase, the detrusor urinae muscle contracts and forces urine out of the bladder, the sphincter muscle relaxes at the same time, and urine flows out of the body.
Symptoms of bladder weakness
- Frequent accidental leaks
- Cannot get to the toilet on time
- Pass small amounts of urine more than eight times daily
- Get out of bed at night to pass urine
- Difficulty urinating when you feel the urge to
- Experience a stop-start urine stream
- Experience a burning sensation when urinating
- Your bladder does not feel empty after urinating
How common is bladder weakness?
- 25% of women 35 years + experience some bladder weakness
- 15% of women 40 years + experience regular / daily bladder weakness
- 40% of women experience bladder weakness during and as a result of pregnancy
- 10% of men 30 years + experience bladder weakness
- Only 10-20% of sufferers seek medical help
Types and causes
This is the most common form of bladder weakness in women but can also occur in men with prostrate problems. The pelvic floor muscles cannot tighten enough to support the urethra and sphincter valve to contain urine in the bladder. It is usually experienced as small urine leaks when laughing, sneezing, coughing, exercising or lifting heavy objects.
This can be described as a strong, sudden, and uncomfortable urge to urinate. It results in involuntary bladder contraction and a big void (emptying of the bladder). Symptoms include urine leaks because the bladder muscles contract at inconsistent times, often contracting regardless of how much urine is in the bladder.
The most common cause of urge incontinence is involuntary muscle contractions as a result of nerve damage to the bladder, nervous system (spinal cord and brain), or to the muscles themselves. Diseases such as Multiple Sclerosis, Parkinson’s, Alzheimer’s, stroke and injuries (including those that occur during surgery) can harm bladder nerves of muscles.
Overflow incontinence is a continual leakage of small amounts of urine due to an over full bladder that doesn’t empty completely. Less common factors include an enlarged prostate, bladder dysfunction of blockages such as bladder stones.
This type occurs when a person recognises the need to urinate but cannot get to the bathroom in time for various reasons including poor eyesight, mobility, depression and anxiety.
This is a shorter-lived form of bladder weakness. It’s caused by anti-depressant, diuretic and blood pressure medication, urinary tract infections and inflammation of the urethra or vagina as a result of thinning tissue due to menopause. It can also be the result of low fluid intake, irritants (caffeine, alcohol, nicotine), citrus fruits, sugar, dairy products, high levels of calcium, high levels of sugar in the bloodstream, depression, and delirium.
5 Healthy bladder tips
- Do not reduce your fluid intake as this can actually make urine more concentrated, aggravate the bladder and make it more active. Recommended intake is 6-8 glasses of fluid daily, preferably water or herbal tea.
- Being overweight increases abdominal pressure so it’s important to maintain a healthy weight. Incorporate a bladder-friendly diet with plenty of vegetables, fruit, and fibre to stimulate your metabolism.
- Try to avoid going to the toilet “just in case”. This will ultimately cause a reduction in bladder capacity so you will need to “go” more often. Hovering over public toilets (an unnatural position) prevents normal voiding. Rather use disposable toilet seat covers if necessary.
- Quit smoking. Nicotine irritates the bladder lining and chronic coughing weakens the pelvic floor and contributes to the onset of stress incontinence.
- Look after your pelvic floor muscles as these support the womb (in women), bladder and bowels. A healthy pelvic floor holds the bladder in place and keeps the urethra, through which urine passes, tightly closed.
LEVELS OF BLADDER WEAKNESS
In a 24 hour time period:
Light: 250 ml
Moderate: 250 to 800 ml
Heavy: 800 to 1 500 ml
Severe: more than 1 500 ml
DIAGNOSIS AND TREATMENT
Levels of incontinence can vary from a few drops to full bladder content loss. Your doctor might ask you to keep a bladder diary and samples of your urine and blood might be taken for testing. There are also specially designed incontinence care products available to provide you with the maximum dignity and comfort. In addition to being superabsorbent the right product can neutralise unpleasant odours.