A leaky bladder can be embarrassing and troublesome to deal with. Studies show that an average of 7% of men and 10% of women experience bladder leakage, with this percentage increasing drastically in older patients. However, with medical treatments and lifestyle modifications, bladder leaks can be controlled.
What Causes Bladder Leaks?
Bladder leaks, also known as urinary incontinence, is the inability of the bladder to hold in urine. Types of incontinence vary and include:
- Urge incontinence – a sudden feeling of an intense urge to pee, which is soon followed by urine leakage
- Stress incontinence – urine leakage with stress is exerted, e.g., when sneezing or coughing
- Overflow incontinence – the bladder is unable to fully evacuate when peeing, which causes frequent urine leakage
- Complete incontinence – the bladder is unable to hold the urine at all, causing constant leakage
- Mixed incontinence – it is possible for different types of incontinence to occur simultaneously
Transient Causes of Bladder Leaks
Some foods, drinks, and certain medications can exasperate bladder leaks, including:
- Foods with lots of sugar or sugar substitutes
- Spicy foods
- Citrussy fruits
- Blood pressure medications
- Muscle relaxants
Medical Causes of Bladder Leaks
Bladder leaks can happen as a result of several underlying medical or physical conditions, such as:
Urinary Tract Infections – Infections of the urinary tract can cause bladder irritation, leading to urine leakage.
Aging – In addition to increased rate of involuntary contractions of the bladder, the bladder muscles start to lose their elasticity with age, diminishing the bladder’s capacity to hold in urine.
Pregnancy and Giving Birth – During pregnancy, hormonal changes along with the increased weight of the baby can cause the bladder to leak. After giving birth through vaginal delivery, the bladder may be pushed down out of its place, which can also cause urine leaks.
Prostate Cancer – Stress or urge incontinence can be related to the direct pressure of an enlarged cancerous prostate on the bladder. Bladder leaks can also be a side effect of prostate cancer treatment.
Prostate Enlargement – Benign enlargement of the prostate, known as benign prostatic hyperplasia (BPH), can also cause bladder leaks as a result of pressure on the bladder.
Constipation – Being located near the bladder and having similar nerve supply, cases of constipation may also lead to bladder leaks.
Urinary Obstruction – An obstructed urine flow can diminish the ability of the bladder to fully evacuate in one go, which leads to frequent urination and bladder leaks.
Neurological Dysfunction – Bladder leaks can be caused due to dysfunctional nerve signals reaching the bladder, which can happen with stroke, Parkinson’s disease, and other nervous system disorders.
Treatment of Bladder Leakage
A urologist can assess your case and recommend suitable treatment options. In most cases, a combination of treatment options is recommended to effectively tackle the problem.
Treatment options for bladder leaks depend on the cause and can include simple lifestyle modifications, medical treatment, and surgical interventions.
Lifestyle Modification for Treatment of Bladder Leaks
Committing to some simple techniques can help avoid or improve the case of a leaky bladder.
- Emptying your bladder – peeing, waiting for a few minutes, and then peeing again can help ensure a fully evacuated bladder.
- Training your bladder – training your bladder to hold in urine can help strengthen bladder muscles.
- Managing your diet – avoiding spicy foods, caffeine, and alcohol can help regain control over your bladder.
- Doing pelvic floor exercises – these a set of exercises aiming to strengthen your pelvic floor muscles.
Non-Surgical Treatment of Bladder Leaks
Non-surgical treatment options for a leaky bladder include:
- Alpha Blockers – These can help relax bladder muscles, as well as the prostate, enabling the bladder to fully evacuate while peeing.
- Anticholinergic Drugs – Sometimes, an overstimulated bladder can cause urine to leak. Anticholinergic drugs have a calming effect on the bladder, which helps minimize leakage.
- Estrogen – Application of topical estrogen can help increase the tone of the urethra.
- Mirabegron – This drug can help relax bladder muscles, increasing its capacity for holding urine and improving its evacuation.
- Electrical Stimulation – Electrodes are introduced into the rectum or the vagina, and a low-intensity electrical impulse is propagate, resulting in stronger pelvic muscles.
- Botox Injections – Direct injection of Botox in the muscle layer of the bladder can help prevent leaks.
- Bulking Material – A bulking material is injected directly in the tissue around the urethra, which keeps it closed and prevents urine leaks.
- Pessary – A small silicone device that can be inserted into the vagina to help prevent urine leakage from the urethra.
- Urethral Insert – A little device that resembles a tampon. It is placed inside the urethra prior to any stress inducing activity that might cause urine leakage. This device plugs the urethra, preventing leaks.
Surgical Treatment Options for Bladder Leaks
In cases where non-surgical interventions do not give sufficient results, a surgical option may be recommended. Surgical options for urine leakage include:
- Sling Operation – A piece of synthetic mesh, called a sling, is placed under the area where the urethra connects to the bladder. This sling helps keep the urethra closed, which prevents urine from leaking.
- Artificial Sphincter – A small ring filled with fluid is placed around the bladder opening to keep it closed. The ring is controlled with a valve implanted beneath your skin, which, upon pressing, causes the ring to deflate, enabling urination when needed.
- Suspension of the Bladder Neck – An abdominal incision is made from which the bladder neck (the area where the bladder connects to the urethra) is suspended, helping provide the support needed to prevent bladder leaks.
Urology Specialists in Phoenix, Arizona
If you are experiencing bladder leaks and looking for an expert opinion, visit us at Ironwood Urology. Our fellowship-trained, board-certified specialist Dr. Desiderio Avila can provide you with the information, treatment, and care you deserve.