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Leaking Urine

Published: 5 décembre 2008
Dear TeenHealthFX,
so for a few months now i have been having "spotting" or "leakage" or urine? like it's usually not that much. but sometimes its more than others. some days i wont have any leaks, and others ill have a lot. i dont understand? i would go to the doctor, but right now we dont have any insurance so i cant and i really want to find out some answers because its extremely uncomfortable! is there anything i can do to help these random leaks i have no controll over without going to the doctor? atleast for now? please help me D: its horrible beyond beleif.
Signed: Leaking Urine

Dear Leaking Urine,

 

What you are describing is a type of urinary incontinence, which is the inability to control the release of urine from your bladder. The problem varies in how severe it is from person to person, with some people having minor leaks to others frequently wetting their clothes.

 

The types of urinary incontinence include:

 

  • Stress incontinence: This occurs when the sphincter muscle at the bladder is weakened. So when pressure is exerted on the bladder (by coughing, sneezing, laughing, exercising, or lifting something heavy), there is a loss of urine. This is one of the most common types of incontinence and often affects women.

 

  • Urge incontinence: Also referred to as “overactive bladder,” with urge incontinence the bladder contracts even when it isn’t full so there is a sudden, intense urge to urinate, followed by an involuntary loss of urine. Those with urge incontinence may need to urinate often, wake up frequently in the night because of the need to urinate, leak when going from sitting to standing, and feel the urge to go when hearing water running or from drinking a small amount of liquid. Urge incontinence may be caused by bowel problems or damage to the nervous system associated with multiple sclerosis, Parkinson’s disease, Alzheimer’s disease, stroke, or injury.

 

  • Overflow incontinence: Inability to empty the bladder, leading to overflow. You may feel like you never completely empty the bladder, or may produce only a weak stream of urine when you go to the bathroom. This can be caused in people with a damaged bladder or blocked urethra, in men with prostrate gland problems, or in people who have suffered nerve damage caused by diabetes, or from the use of certain medications.

 

  • Mixed incontinence: Experiencing symptoms of more than one type of urinary incontinence. Usually one type is more bothersome than the other.

 

  • Functional incontinence: Physical or mental impairment keeps a person from making it to the bathroom in time to go. This occurs mainly with older adults in nursing homes.

 

  • Gross total incontinence: Continuous leaking of urine, day and night, or periodic large volumes of urine and uncontrollable leaking because the bladder has no storage capacity. People with this type of incontinence usually were born with an anatomical defect, had a spinal cord injury or injury to the urinary system, or have an abnormal opening between the bladder and an adjacent structure, such as the vagina.

 

When To See Your Doctor:

 

  • If you have blood in your urine, you should see your doctor as the urinary incontinence may indicate a more serious underlying medical problem.
  • If urinary incontinence is causing you to restrict your activities, limit your social life, and/or causing significant embarrassment or emotional distress.
  • If your incontinence is frequent or affecting your overall quality of life.

 

If you do not have insurance, check with your local hospital, former primary care physician, or school nurse to see what programs may be available in your area to you and your family to provide you with supplemental insurance so that you can see a doctor and get the treatment you need.

 

Treatment Options:

 

Treatment for urinary incontinence depends on the type of incontinence, the severity of the problem, and the underlying cause. Most people treated for urinary incontinence see a dramatic improvement in their symptoms. Treatment options fall into four broad categories (listed below), and in most cases your doctor will start with the least invasive treatments first before moving to other options.

 

1. Behavioral Techniques

 

  • Pelvic floor exercises: Also known as “Kegels” these exercises strengthen your urinary sphincter and pelvic floor muscles that help control urination. Kegels are often recommended to those with stress incontinence. To do Kegels, imagine that you are trying to stop your urine flow. Squeeze the muscles you would use and hold for a count of three. Relax, count to three, then repeat. You can do these exercises anywhere (while doing homework or watching tv). Try to do 20 repetitions three times a day.

 

  • Bladder training: Learning to delay urination after you get the urge to go. You may start by trying to hold off for 10 minutes every time you feel an urge to go, and then try increasing the waiting period to 20 minutes. The goal is to lengthen time between trips to the toilet until you are urinating every 2-4 hours. Bladder training may also involve voiding – urinating and then waiting a few minutes and trying again to avoid overflow incontinence.

 

  • Scheduled toilet trips: Timed urination, going to the toilet (every 2-4 hours) according to the clock rather than urge.

 

  • Fluid and diet management: Cut back and avoid alcohol and caffeine. Cut back on acidic foods if they irritate the bladder. Reducing liquid before bedtime. Losing weight can also help with the problem.

 

2. Medications

 

There are several different kinds of medications that can help with urinary incontinence. Some are made to calm an overactive bladder, others help the bladder to relax. Antibiotics can help if the incontinence is due to a urinary tract infection or inflamed prostrate gland. Other medications may help to relax the urinary sphincter or make the bladder contract more.

 

3. Surgery

 

If other treatments are not working, several surgery procedures are available to address certain problems causing urinary incontinence. The most common types of surgery are artificial urinary sphincter, bulking material injections, sacral nerve stimulator, sling procedure, and bladder neck suspension.

 

4. Absorbent pads and catheters

 

If medical treatment can’t completely eliminate your incontinence, or you need help until treatment starts to take effect, there are products available to help ease the discomfort and inconvenience of leaking urine. However, these products should be a last resort as most people will benefit from other available treatments.

 

  • Pads and protective garments: Products range from drip collectors (for men), panty liners or pads worn in the underwear, adult diapers (in disposable and reusable forms), plastic underwear worn over regular underwear, and underwear and briefs with waterproof panels. These products can be purchased at drugstores, supermarkets, and medical supply stores.

 

  • Catheter: If you are incontinent because your bladder does not empty properly, your doctor may recommend that you learn to insert a soft tube (catheter) into your urethra several times a day to drain the bladder. This gives more control of leakage, especially with overflow incontinence. In rare cases of extreme illness, people have to keep the catheter in constantly. The catheter is connected to an external bag to hold urine, and the bag is emptied as needed.

 

 

FX recommends that you find a way to meet with a doctor so that you determine the type of urinary incontinence and the proper treatment for that type. In the meantime, since stress incontinence is one of the most common forms of incontinence, try doing Kegel exercises to see if this helps the problem, and find a comfortable type of pad to use until your incontinence is more under control.

 

If you don't have a doctor and live in northern New Jersey, you can call the Adolescent/Young Adult Center for Health at 973-971-6475 or contact your local teen health center to see what options are available to you given you currently do not have health insurance. Again, check with your local hospital, former primary care physician, or school nurse to see what programs may be available to you and your family to provide you with supplemental insurance so that you can see a doctor and get the treatment you need.

Signed: TeenHealthFX

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