Bladder Control Problems in Women

Bladder Control Problems in Women

Bladder is one of the essential components of a functional urinary system. It is located in the pelvic region in close proximity to organs like vagina, uterus, cervix and median umbilical ligament (in females). Human urinary bladder is a pouch like structure that serves two important functions in the body; which are:

• Storage of urine that is produced and transported from the kidneys
• Expulsion or removal of the nitrogenous waste products from the body (via the process of micturition)

It is imperative to understand that any abnormality in the formation or excretion of urine can greatly compromise the quality of life and overall health. It has been observed that bladder issues are more common around the extremes of age (very young children due to congenital malformations and elderly due to deleterious effects of physiological aging).
Some of the most significant bladder control problems include inability to store urine, problems in passing urine, incomplete voiding of the bladder, alteration in the frequency of urination (such as overactive bladder) etc. There is misconception that bladder control problems are normal in elderly population and requires only conservative management, which is wrong. It is highly advised to seek the help of a registered healthcare professional if you are experiencing bladder issues for prompt management.
According to a study published in the scientific journal Urology (1), investigators reported that the overall prevalence of urinary incontinence in females is 25 to 45%.
 

Causes of Bladder Control Problems in Women

The regulation of the bladder activity involves both voluntary and involuntary regulation. This also indicates that your bladder require efficient feedback from both the central nervous system as well as the muscles of the urinary bladder (and skeletal muscles that forms the urinary sphincters). Any disconnect or malfunction in the activity of these two systems can lead to bladder control problems. Following are the primary causes of bladder control issues in females:

• A positive history of neurogenic disorders/ conditions such as Parkinson’s disease, multiple sclerosis, traumatic head injuries, polio etc.
• Spinal cord injuries (transient or permanent)
• A history of spinal surgery or malignancy
• A history of significant damage to the lower pelvic region
• Obesity – increased weight put more pressure on your pelvic region; thereby leading to bladder control dysfunction

Possible Risk Factors for Bladder Control Problems

Following are risk factors that can initiate the problem of bladder control (3),

• History of multiple pregnancy or troubled vaginal deliveries (such as obstructed labor, prolonged labor etc.)
• Loss of protective influence of estrogen (due to menopause or hysterectomy) can lead to bladder control problems as a result of muscular atony (or loss of muscle strength)
• Progressive degeneration of bladder tissues due to advanced aging
• Diabetes mellitus (neuropathy and loss of sphincter control that may present as dribbling of urine on coughing or laughing).

Signs and Symptoms of Bladder Cancer Problems

It is often fairly difficult to diagnose the bladder issues mainly because the symptoms of bladder dysfunction may overlap with the normal variations in the bladder activity. However, following signs and symptoms are often suggestive of an ongoing disease or pathology.

• Leakage or dribbling of urine after exposure to sudden pressure such as cough and sneezing
• An inability to hold urine despite voluntary control
• Increased frequency of urination (though volume of urine remains small, indicating a storage dysfunction)
• Pain and difficulty in passing the urine

If you are experiencing these issues, it is strongly advised to see your doctor for prompt diagnosis and early management.
 

Management of Bladder Control Problems

Generally bladder control problems responds very well to bladder retraining and conservative management; however in some cases the patient may require medical treatment for resolution of symptoms. Maintaining your life style is a key factor in managing this disease. Given below are tips for managing bladder control problems,

• Maintain your fluid intake: Too much fluid intake can result in urgency of urination and increased frequency while too little fluid intake can increase the risk of dehydration and renal issues. It is important to divide your daily fluid requirement evenly throughout the day to prevent bladder overload.
• Avoid use of products that increases the risk of bladder irritation: Certain foods have a tendency to irritate the bladder lining and its surrounding tissues. Excessive use of caffeine and alcohol promotes diuresis (increase frequency of urination). Use of acidic fruits such as oranges, lemons etc. results in hyper tonicity of bladder tissue that may lead to irritation of bladder mucosa.
• Adjust your habits: This bladder problem increases the frequency of urination and as a result you needs to go washroom again and again. This urgency may create a lot of problems for you. Try to retrain your bladder by strategies like

1. Notice your urination pattern for few days.
2. Relax your mind and try to stay calm.
3. Try to increase your urination intervals.
4. Perform kegel exercises to strengthen your bladder muscles (and sphincters) in order to prevent the dribbling of urine.
5. Speak to your doctor regarding pharmacological options such as anti-spasm medications etc.)

 
References:

1. Buckley, B. S., & Lapitan, M. C. M. (2010). Prevalence of urinary incontinence in men, women, and children—current evidence: findings of the Fourth International Consultation on Incontinence. Urology, 76(2), 265-270.
2. Muller, N. (2005). What Americans understand and how they are affected by bladder control problems: highlights of recent nationwide consumer research. Urol Nurs, 25(2), 109-15.
3. Bronner, G., Elran, E., Golomb, J., & Korczyn, A. D. (2010). Female sexuality in multiple sclerosis: the multidimensional nature of the problem and the intervention. Acta Neurologica Scandinavica, 121(5), 289-301.