How Do You Know When Your Bladder Is Empty

What Facts Should I Know Bladder Control Problems (Incontinence)?
What Causes Bladder Control Bug?
What Are Types of Float Command Problems?
What Are the Symptoms and Signs of Bladder Control Problems?
When to Seek Medical Care for Bladder Command Problems (Incontinence)
How Are Bladder Control Bug (Incontinence) Diagnosed?
What Is the Treatment for Bladder Command Problems?
What Are Home Remedies for Bladder Control Problems (Incontinence)?
What Is the Medical Treatment for Bladder Control Bug (Incontinence)?
What Medications Treat Bladder Control Problems (Incontinence)?
Is there Surgery for Bladder Control Problems (Incontinence)?
What Is the Follow-upward for Bladder Control Problems (Incontinence)?
How Can Y'all Prevent Bladder Command Problems (Incontinence)?
What Is the Prognosis for Bladder Control Issues (Incontinence)?
Support Groups and Counseling for Bladder Control Problems (Incontinence)
Bladder Command Problems Topic Guide
Doctor'southward Notes on Float Control Issues Symptoms

What Facts Should I Know Float Command Issues (Incontinence)?

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People who have bladder control problems take trouble stopping the flow of urine from the bladder. They are said to accept urinary incontinence. Incontinence is uncontrollable leaking of urine from the float. Although urinary incontinence is a common problem, it is never normal.

Incontinence is both a health trouble and a social trouble.

Most people with incontinence endure social embarrassment. Many become depressed and limit their activities away from home, frequently becoming socially isolated and lonely.

Why tin can I not concur my pee?

Physical conditions linked to incontinence include infection, peel irritations and infections, falls, fractures, and sleep disturbances.
Many people with incontinence are too embarrassed to talk to their physician about it. They "cope" or "only learn to live with it." This is irresolute gradually as people realize that help is available.
A pregnant pct of elderly people who live at dwelling and in nursing homes are affected by urinary incontinence. Incontinence is a major reason for people going into nursing homes. However, it is not an inevitable upshot of aging.

Here is a brief description of the urinary organisation and the process of urination (micturition):

The urinary system is equanimous of the kidneys, ureters, float, and urethra.
The kidneys filter h2o and waste from the blood. They excrete urine, which passes via the ureters to the bladder. The bladder stores urine until you lot urinate.
The kidneys typically excrete nigh 1-i½ quarts (i,000-1,500 mL) of urine in 24 hours.
The float is a hollow, muscular organ. The bladder wall includes a smooth muscle known as the detrusor muscle. The bladder'due south size, shape, position, and relation to other organs vary with age and the amount of urine stored.
The urethra is a narrow tube connecting the bladder with the opening when the urine comes out of the body. Surrounding the urethra are sphincter muscles, which partly control release of urine from the bladder and from the body.
Although the bladder is able to hold well-nigh 600 mL of urine, the urge to urinate develops one time the bladder contains 300 mL. As the bladder starts to stretch, nerves in the bladder and surrounding surface area send letters to the brain, via the spinal string, telling it that the bladder is filling. The encephalon sends dorsum the urge to urinate.
Although you normally make the choice when to urinate, once yous make up one's mind to exercise so the nervous arrangement takes over and the process becomes automated. The detrusor contracts and the sphincters relax to let urine to flow. When the bladder is empty, the sphincters contract and the detrusor relaxes.
Yous can stop or concur off urination past contracting (squeezing) the external sphincter, which causes relaxation of the detrusor. Urine is stored, and the urge to urinate is temporarily stopped.
As you continue to produce urine, however, the messages to and from the brain go more urgent, and the urge to urinate becomes even stronger.

Urinary incontinence is believed to bear upon at least xiii one thousand thousand people in the United States.

That number may even be higher, and it is expected to increase sharply with the crumbling of the babe boomers.
Incontinence affects both sexes and all ages only is most common in older people.
Incontinence is much more than common in women than in men. Well-nigh men with incontinence are older and suffer from some type of prostate disease.

How can I regain float control?

The good news about urinary incontinence is that information technology is treatable. A great majority of people with bladder control problems can be helped by treatments that are bachelor now. If incontinence cannot be cured, information technology tin can at least be controlled.

What Causes Float Control Problems?

Incontinence is a symptom with a wide variety of causes. The most common causes include the post-obit:

Urinary tract infection
Side result of medication: Examples include alpha-blockers, calcium channel blockers, antidepressants, antihistamines, sedatives, sleeping pills, narcotics, caffeine-containing preparations, and water pills (diuretics). Occasionally, the medicines used to treat some forms of incontinence can besides worsen the incontinence if not prescribed correctly.
Impacted stool: Stool becomes so tightly packed in the lower intestine and rectum that a bowel move becomes very difficult or impossible.
Weakness of muscles in the float and surrounding area: This tin can have a variety of causes.
Overactive float
Bladder irritation
Blocked urethra, usually due to enlarged prostate (in men)
Prior prostate, bladder, or pelvic surgery
Nervus damage or neurological diseases (spinal cord injury, stroke, etc.)

Many of the causes are temporary, such equally urinary tract infection. The incontinence improves or goes abroad completely when the underlying condition is treated. Others are longer lasting, but the incontinence can usually be treated.

Risk factors: Underlying causes or contributors to urinary incontinence include the following:

Smoking: The connection with incontinence is not completely articulate, but smoking is known to irritate the bladder in many people.
Obesity: Backlog body fatty can reduce muscle tone, including the muscles used to control urination.
Chronic constipation: Regular straining to accept a bowel movement can weaken the muscles that control urination.
Diabetes: Diabetes can damage nerves and interfere with sensation.
Spinal string injury: Signals between the bladder and the brain travel via the spinal cord. Damage to the cord can interrupt those signals, disrupting bladder function.
Disability or impaired mobility: People who have diseases such equally arthritis, which brand walking painful or slow, may accept "accidents" earlier they can achieve a toilet. Similarly, people who are permanently or temporarily confined to a bed or a wheelchair often have problems because of their inability to become to a toilet easily.
Neurologic affliction: Conditions such as stroke, multiple sclerosis, Alzheimer'south disease, or Parkinson'southward illness can crusade incontinence. The trouble can exist a direct event of a disrupted nervous system or an indirect result of having restricted motion.
Surgery or radiation therapy to the pelvis: Incontinence can outcome from certain surgeries or medical therapies.
Pregnancy: 1-third to one-half of pregnant women have problems decision-making their float. In most of these women, incontinence stops subsequently delivery. However, 4%-8% of pregnant women experience renewed incontinence later delivery (postpartum). Risk factors for postpartum incontinence include vaginal delivery, long 2d stage of labor (the time after the neck is fully dilated), and having big babies.
Menopause: Studies accept not demonstrated a consistent increase in take a chance of incontinence following menopause. The relationship between postmenopausal hormone replacement therapy and incontinence is unclear.
Hysterectomy: Women who accept had a hysterectomy may take incontinence later in life.
Enlarged prostate: In men with an enlarged prostate, the prostate tin block the urethra, causing urine leakage. However, less than i% of men treated for beneficial (noncancerous) enlargement of the prostate report incontinence.
Prostate surgery: Up to 87% of men whose prostate has been removed report problems with incontinence.
Bladder disease: Certain disorders of the bladder, including bladder cancer, can sometimes cause incontinence.

SLIDESHOW

Urinary Incontinence in Women: Types, Causes, and Treatments for Bladder Control See Slideshow

What Are Types of Float Control Bug?

There are several types of urinary incontinence. Many people accept more than 1 type. A combination of stress and urge incontinence is especially mutual. Stress and urge incontinence are the most common types.

Stress incontinence: This occurs when you do anything that strains the muscles around the bladder, such as laughing, coughing, sneezing, bending, or even walking in some people. It is acquired past weakness or injury to the muscles of the pelvis or the sphincters. The underlying causes include physical changes due to pregnancy, childbirth, or menopause. It is a frequent blazon of incontinence in women.
Urge incontinence: This is a sudden uncontrollable desire to urinate regardless of how much urine is in the bladder. Information technology is believed to be caused past inappropriate contractions of the float. The term "overactive bladder" has been adopted to draw urge incontinence, detrusor instability, and hypersensitive detrusor. Urgency, frequency, and urination at night (nocturia) are common in people with this condition. This is due to disruption of signals between the bladder and the brain. Environmental cues, such as running water or putting the fundamental in the front door, may prompt urgency or leakage. It is a frequent type of incontinence in both men and women.
Mixed incontinence: This is a mixture of stress and urge incontinence.
Overflow incontinence: This results when you retain urine in your bladder either because your musculus tone is weak or you lot have some sort of blockage below your bladder. Symptoms include dribbling, urgency, hesitancy, depression-force urine stream, straining, and urinating only a small corporeality despite a sensation of urgency. It is a frequent blazon of incontinence in men.
Neuropathic incontinence: This results from a problem affecting one or more than nerves. Either the detrusor muscle overcontracts or the interior sphincter lacks the tension to hold urine in.
Fistula: This is an abnormal internal connection betwixt organs or structures such as the bladder, ureters, or urethra. This can cause incontinence.
Traumatic incontinence: This is incontinence that occurs after injury to your pelvis (such as a fracture) or as a complication of surgery.
Congenital incontinence: This may occur in people born with their bladder or one or both ureters.
Obstacle to urine menses: This may cause incontinence.

The post-obit seem to accept niggling or zilch to do with causing float control bug:

Bug or delays in toilet training in childhood (However, some testify links childhood voiding dysfunction with adult voiding dysfunction, that is, incontinence.)
Having a parent with a float control trouble

What Are the Symptoms and Signs of Bladder Command Problems?

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Incontinence is a symptom itself. Information technology is uncontrollable leakage of urine from the bladder. Words used to describe float control problems include the post-obit:

Urgency: The feeling of having to urinate very soon
Hesitancy: When trying to urinate, difficulty getting a urine stream going
Frequency: Having to urinate oft
Dysuria: Pain or burning with urination (This is usually associated with a float infection.)
Hematuria: Blood in the urine (cherry-red or pinkish urine)
Nocturia: Urination at night (having to wake up to urinate)
Dribbling: Continuing to drip or distill urine subsequently finishing urination
Straining: Having to clasp or bear downwardly on the external sphincter to urinate

Some people with incontinence feel the following problems:

Bedwetting (nocturnal enuresis) can stem from a blockage, nervus problem, or some unknown cause. It is most common in children younger than 3 years of age, but information technology occurs in 15% of children 3-v years of age and in 1% of school-aged children. The percentages decrease as children get older.
Dribbling incontinence occurs immediately after urination. In men, it may result from retained urine in the urethra in front of the sphincter. In women, it may result from retained urine in a urethral diverticulum (a saclike outpouching of the urethral wall).
Functional incontinence occurs if you are unable to reach the bath. You may physically "not make it" or not know you need to urinate because of some mental disability.

When to Seek Medical Care for Bladder Control Problems (Incontinence)

If you lot have a problem with urine leakage or have to get up more than twice in the night to urinate, brand an appointment with your health-intendance provider. The trouble may exist caused by a medical condition that can be treated. You owe it to yourself to detect out. Most likely y'all do non have to resign yourself to living with incontinence for the balance of your life.

If you take kept records of urination ("urination diary"), have a copy with y'all to the appointment. Be prepared to provide a complete list of your medications, including nonprescription drugs, herbs, and supplements.

How Are Bladder Control Issues (Incontinence) Diagnosed?

Your health-care provider will inquire questions nigh your symptoms and the situations in which you experience urine leakage. He or she will also ask you about your medical and surgical history, medications, and habits. A thorough concrete examination will include your abdomen, pelvis (women), rectum (men), and nervous system.

You may be referred to a specialist. Physicians who specialize in diagnosing and treating disorders of the urinary tract include urogynecologists and urologists.

A physical test should be performed. In women, a thorough vaginal and pelvic exam forth with a rectal exam should be performed. The quality of the tissue, the caste of prolapse (bladder descent), and evaluation of masses or tissue support is documented.

In men, an exam of the genitalia with attending to the urethral meatus (opening) and a rectal exam are performed. The character and size of the prostate are evaluated.

Which tests are performed depends on which type(s) of incontinence your health-care provider suspects. A urine sample will be nerveless.

The amount and advent of the urine will exist recorded.
The chemistry of the urine volition be analyzed (urinalysis).
The urine will be looked at under a microscope to check for infection and other abnormalities.
The urine will be cultured. A smear of urine is put in a pocket-size sterile dish and allowed to sit down for a few days. If any bacteria grow on the dish, you probably have a urinary tract infection.

Postvoid rest measurement: This measures how well you are able to empty your bladder when you urinate. This is washed for people whose symptoms advise overflow incontinence. The measurement can be done in either of two ways.

You lot will commencement be asked to urinate normally. In men, a uroflow examination is normally obtained to measure the velocity and character of the urinary stream. This can also be washed in some women.
The kickoff technique involves tapping your bladder after urination to see how much urine remains. The tap is done with a sparse, soft plastic tube called a catheter. The catheter is inserted into your urethra and up into your bladder, and the urine flows out.
The 2nd technique uses an ultrasound device to "take a picture" of the bladder. From this flick, the operator can calculate how much urine remains in the bladder.

Blood tests are not usually helpful, only your health-intendance provider may perform sure tests to rule out specific medical weather condition.

A cotton wool swab test may exist done. This evaluates the urethra for hypermobility. (Many women with stress incontinence have hypermobility.) A well-lubricated, sterile, cotton wool-tipped applicator is inserted through the urethra into the bladder neck. This is done in a lying-down position.

Urodynamic tests are used to discover how well the muscles of the bladder and sphincter are working. A series of these tests tin can measure your float chapters and how well your sensation reflects that. They tin also tell whether your bladder fills and empties in a normal way. This test is often described as an "EKG of the bladder."

Cystoscopy is a technique that allows the doctor to view the inside of the float. A thin tube is inserted into your urethra and up into your bladder. This is a very of import test for those people who take blood in their urine (hematuria) and for those with meaning irritative voiding symptoms, especially in people who smoke.

What Is the Treatment for Bladder Command Issues?

Many people who have incontinence practice not seek treatment because they believe the but handling available to them is surgery. This is a misconception; treatments for incontinence include behavioral, medical, and surgical approaches.

Generally, behavioral therapies are the first option; because they are noninvasive and take no side effects, they are the safest. A variety of medical treatments are available. Surgery is usually reserved for people whose problem does not ameliorate with behavioral and medical therapy.

Your overall medical condition, the type of bladder control problem y'all have, and your lifestyle will all determine which treatments are correct for yous. Talk to your health-care provider; together y'all can come up with a treatment plan that works for you.

What Are Home Remedies for Bladder Command Issues (Incontinence)?

Incontinence is never normal. If y'all have a problem with urine leakage, y'all should see a medical professional.

While waiting for your appointment, make yourself more than comfortable.

Avoid foods and drinks that may irritate the bladder. These include alcohol, caffeine, carbonated drinks, chocolate, citrus fruits, and acidic fruits and juices.
Exercise not drinkable likewise much fluid; 6-8 cups a day is adequate, but you may need more if yous are exercising, sweating a lot, or the weather is hot. In people with kidney stone disease, voiding at least 2 liters of fluid per twenty-four hour period is of import. Fluid brake may atomic number 82 to stone growth or formation.
Urinate regularly.
Practise not ignore the urge to urinate or to accept a bowel movement.
If you are overweight, try to lose weight and reach a healthier weight.
If necessary, wear absorbent pads to catch urine.
Maintain proper hygiene. This will help you lot feel more confident and will prevent odors and pare irritation.

Kegel exercises: Exercising the muscles of your pelvic floor may do good women with either stress or urge incontinence.

The exercises involve strongly contracting the pelvic muscles that you lot utilise to concur dorsum urine.
Many women are familiar with these exercises from childbirth classes.
To discover the muscles, place the kickoff and second fingers of one of your hands into your vagina. Squeeze every bit if holding urine in until you feel a tightening around your fingers.
Tightening these muscles is the exercise. Clasp and hold for at least ten seconds, then relax for 10 seconds. Echo these exercises at to the lowest degree ten-20 times, iii times per twenty-four hour period. The more frequently y'all do the exercises, the more probable that they will work.

Create a urination diary. Accept notes every twenty-four hour period on your urination patterns. This will help your health-intendance provider in diagnosing your problem:

Time of urge to urinate (or if in that location was no urge)
Strength of pain or urge
Fourth dimension you actually urinated
Volume of urine
Corporeality of leakage
Blazon and amount of fluids you lot drink and when you drink them

A relatively new simply promising new treatment is biofeedback. It has been shown to make a significant difference in the pediatric population. Because many people with incontinence take pelvic floor dysfunction from unidentifiable causes, it is felt that bladder retraining may improve many people with incontinence. Biofeedback consists of pelvic muscle tightening and relaxation with a trained technologist facilitating the sessions. This treatment does require a dedicated person but may eliminate the demand for medications and/or surgery.

What Is the Medical Treatment for Bladder Command Problems (Incontinence)?

Handling depends of the type and severity of the incontinence. Many of these treatments require a commitment on your office to main the technique and practice it daily. Hash out all of the treatment options with your health-intendance provider before making a decision together.

Some medications that yous may take for other medical weather can cause incontinence. Review your medications with your wellness-care provider. If a medication is causing the problem, an alternative may be available.

Urge incontinence: Treatment is focused on eradicating the underlying cause. If your health-care provider is unable to place a reversible cause, the focus of treatment becomes reducing symptoms. Handling may include the following:

Providing a commode or urinal for urination "emergencies"
Limiting fluid intake
Behavioral therapy: Irresolute your habits to try to reduce incontinence
Timed voiding and float training regimens: Gradually prolonging the time betwixt urination
Pelvic floor exercises: To strengthen the sphincter muscles
Pelvic floor electric stimulation: Painless electrical pulses applied via a small probe in the vagina or rectum to increment tone of the pelvic floor muscles
Medications: To relax the bladder or tighten the sphincter muscles

Stress incontinence: In general, surgical treatment is far more successful than nonsurgical handling. Medications by and large do not work well in stress incontinence. Nonsurgical methods cure very few people, although symptoms may improve for upwards to 88%.

If overweight, work toward weight loss. Weight loss can cure incontinence in as many as half of cases.
Kegel exercises
Weighted vaginal cones: Strengthen pelvic muscles to preclude involuntary catamenia of urine
Urethral plug: A pocket-size tampon-like insert placed into the urethra to block urine flow
Topical estrogen cream: Applied in the vagina, for use only after menopause (Many people are reluctant to utilize estrogen cream because of its potential association with female malignancies. Topical estrogen, nonetheless, is a very good handling for those who need replacement and the risk is negligible.)
Pessary: A device worn by women in the vagina to aid back up the bladder and improve control
Barrier devices: Work similar pads merely are much smaller and less bulky
Pelvic flooring electrical stimulation
Medication: To increase the tone of the internal sphincter, not always effective

Overflow incontinence: No constructive medication is available for this condition, which usually occurs in people with longstanding diabetes, bladder outlet obstruction, or lumbar spine injury/illness. The cornerstone of treatment is catheterization.

A catheter is a thin tube that goes through your urethra to your bladder to drain urine. There are ii different kinds of catheters.
- Ane is an intermittent catheter. You insert this yourself whenever needed, drain your bladder, and remove the catheter. You are taught how to do this by a specially trained nurse.
- The other, chosen a Foley catheter, is worn all the fourth dimension. Urine drains into a bag, usually taped to your leg. You simply replace the bag as necessary. Your health-care provider volition make arrangements for you to have the catheter changed regularly. This type of catheter is used for incontinence only as a terminal resort.

No matter what type of incontinence you have, medical handling can take some fourth dimension to have effect. During treatment, or if medical treatment does non work for you, you lot accept the post-obit alternatives:

Wear an absorbent production
Use a catheter to remove urine
Surgery

What Medications Care for Bladder Control Issues (Incontinence)?

Anticholinergic and spasm-relieving drugs are used in urge incontinence to suppress bladder contraction and relax bladder smooth muscle. This grade of drugs includes darifenacin (Enablex), dicyclomine (Antispas, Bentyl), flavoxate (Urispas), hyoscyamine (Anaspaz, Levbid, Levsin), methantheline (Banthine, Pro-Banthine), oxybutynin (Ditropan, Ditropan Twoscore, Oxytrol), solifenacin (VESIcare), tolterodine (Detrol, Detrol LA), and trospium (Sanctura). Anticholinergic agents may assist save urge incontinence. (Anticholinergic means to oppose or counteract the activity of certain nervus fibers that cause the bladder to contract.)

Myrbetriq (mirabegron) is a beta-three adrenergic agonist indicated for the handling of overactive bladder (OAB) with symptoms of urge urinary incontinence, urgency, and urinary frequency.

Some tricyclic antidepressants (TCAs), such every bit imipramine (Tofranil, Tofranil PM), have strong anticholinergic effects and may be prescribed to care for incontinence. Because the effects of newer, long-interim agents (for example, Detrol LA, Ditropan XL, Enablex, or VESIcare) final throughout the day, they demand to exist taken only in one case daily, which makes them very convenient. Additionally, the effects of Detrol and Detrol LA are mostly express to the bladder, thus lessening the prevalence of side effects typically acquired past anticholinergic medications.

Medications are sometimes used in stress incontinence. These medications can have serious side effects, such as high claret pressure. They are not for everyone. These medications include adrenergic agonists, such every bit midodrine (ProAmatine) and pseudoephedrine (Sudafed), which increase internal sphincter tone.

No medications are effective in treating overflow incontinence. A drug called Urecholine has been FDA approved for overflow incontinence merely has not met with a lot of success in clinical practice.

Run across Understanding Bladder Command Medications for more than data on medications used to treat incontinence.

Is there Surgery for Bladder Control Bug (Incontinence)?

Surgery for urinary incontinence either corrects an anatomical problem or implants a device to alter bladder muscle function.

Most people do non demand surgery, but about of those who have surgery become dry out.
Like any surgery, these procedures exercise not piece of work on everyone. A small number of people are not completely dry after surgery.
Like all surgery, these operations can have complications.
Each of these procedures is appropriate but for a certain blazon or types of incontinence.
A urogynecologist or urologist can advise you about which, if any, might work for you.

Types of operations used in people with incontinence include the following:

Altering the position of the bladder neck, which can change how urine is released from the float
Repairing or supporting severely weakened pelvic floor muscles
Removal of a blockage
Implantation of a "sling" around the urethra
Implantation of a device that stimulates the fretfulness to increase awareness of the need to urinate
Injection of a naturally occurring material called collagen around the urethra (This is an option for women with stress incontinence. This adds bulk to the area, which compresses the urethra. This increases resistance to urine catamenia. Since collagen is slowly captivated into the body, this may have to be repeated.)
Injection of Botox into the bladder muscle using a cystoscope
Surgical placement of an artificial urinary sphincter
Enlargement of the float (considered a concluding resort)

What Is the Follow-upwardly for Bladder Control Issues (Incontinence)?

Follow the recommendations of your doc.

Make and keep regular follow-upwards appointments. You can discuss your progress with your physician, and he or she can tailor your treatment accordingly.

How Can Yous Prevent Bladder Control Bug (Incontinence)?

The following measures tin can help maintain skilful bladder and urinary health:

Beverage enough of fluids.
Avoid alcohol and caffeine.
Urinate regularly.
Avoid foods that irritate your float.
Maintain good health: Eat a healthy diet, maintain a health weight, and engage in some concrete activity daily.
Follow up with your doctor on a regular basis.

What Is the Prognosis for Bladder Control Problems (Incontinence)?

Although treatment may not effect in cure, in most cases, your symptoms will be reduced. For people with stress incontinence, virtually experience either improvement or cure. For people with urge incontinence, some experience cure, and nigh improve.

From

References

Medically reviewed past Michael Wolff, Doctor; American Board of Urology

REFERENCE:

"Evaluation of women with urinary incontinence"
UpToDate.com "Handling of urinary incontinence in women"
UpToDate.com "Urinary incontinence in men"
UpToDate.com

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