Leaks happen. Here’s how your doctor can help.

Do you have trouble making it to the bathroom in time? Or maybe you leak a little when you cough or lift a heavy grocery bag. Or you’re struck with an urge to go when you least expect it. 

You may have a bladder control problem, also known as urinary incontinence. Leaks can affect anyone at any age. But they’re more common in older adults, especially women, according to the National Institute on Aging. Bladder issues can be annoying — and embarrassing. 

Don’t be shy about bringing the situation up with your doctor because bladder problems are treatable. Lifestyle changes are a good place to start. But sometimes you need medical help to get leaks under control. Your doctor can prescribe medications and other treatments to help you stay drier. 

Read on to learn about the various options your doctor might bring up. 

What is urinary incontinence? 

There are many types of incontinence, but two major ones are most common, says urologist Kathleen Kobashi, M.D., chair of the Department of Urology at Houston Methodist Hospital in Texas. One is stress incontinence and the other is overactive bladder, also called urgency incontinence. 

Stress incontinence describes the accidental release of urine during physical activities such as coughing, laughing, or lifting. 

Your urethra is the tube that runs from your bladder to the outside of your body. It’s like the hole where you would blow up a balloon, says Dr. Kobashi. “If the muscle that controls that part of the bladder isn’t tight enough, then anything that strains the area can cause leakage.” 

Overactive bladder describes sudden, frequent, and hard-to-control urge to urinate. The bladder either squeezes when it’s not supposed to or you feel like you’ve got to go all the time. And sometimes you just can’t make it to the bathroom in time, says Dr. Kobashi.   

Need to find a primary care provider to schedule your next annual wellness visit?

Use Find a Doctor on hmsa.com to search for a participating provider near you today.

Find a doctor

Common causes of incontinence  

Your bladder muscle and other parts of the urinary tract get weaker as you age, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). This can make it harder to hold in urine. 

For women, hormonal changes after menopause can lead to urinary incontinence. The condition affects over 50% of postmenopausal women, according to a 2019 review paper. 

For men, age-related changes in the prostate gland play a part in the condition. An enlarged prostate can cause bladder control issues, says the NIDDK. So can recent prostate cancer surgery. This is because the prostate gland is very close to the urinary sphincter muscle. Surgery may loosen the sphincter, which controls the flow of bladder. 

Your diet plays a huge role in your bladder health as well, according to the National Association for Continence. Eating the wrong foods may make your symptoms worse. Foods and drinks that can irritate your bladder include:  

• Citrus fruits and juices 
• Caffeine 
• Strawberries 
• Raw onion  
• Tomatoes 
• Spicy foods 
• Alcohol 
• Carbonated beverages (soda, seltzer) 
• Foods containing artificial sweeteners 

Some prescription and over-the-counter medications can also cause incontinence or make it worse. 

6 treatments your doctor might suggest 

Treatments range from lifestyle changes to medications to surgical procedures. Doctors may recommend: 

Certain lifestyle changes: The first line of therapy is often to modify your diet, says Dr. Kobashi. Cutting back on foods and drinks that irritate the bladder can improve symptoms. Your doctor may also suggest doing pelvic floor exercises called Kegels. These can help strengthen your bladder muscles. 

(To learn about other at-home strategies, check out Proven ways to manage urinary incontinence.)  

Pessary: Women with incontinence may consider a device called a continence pessary. This is a flexible silicone ring that’s placed in the vagina. It pushes up on the urethra and helps it stay closed until you need to urinate. Your doctor can fit you for one. 

Medications: This is typically only recommended if lifestyle changes don’t help, says Dr. Kobashi. There are a few types of medication that doctors can use to calm the bladder: 

• Anticholinergics. This type of medicine stops your bladder from squeezing uncontrollably. It blocks a chemical in your body that tells your brain you have to go to the bathroom even when you don’t. There are many types of this medication, which come in pills, tablets, and skin patches. 
• Beta-3-receptor agonists. These medications relax the bladder muscles. They also allow your bladder to hold more urine. 
• Vaginal estrogen. Women with incontinence may be prescribed estrogen. During menopause, your body loses estrogen. This medication can help replace some of those hormones. Your doctor may give you a ring, patch, or cream. 

Injections: You may have heard of Botox as a treatment to smooth facial wrinkles. But Botox can also be injected into the wall of the bladder to relax the muscles. Doctors might suggest this if medication and lifestyle changes don’t help. “It’s very successful,” says Dr. Kobashi. It lasts about six months. Another option is a type of filler that’s injected into the urethra area to plump it up a little. This procedure is typically used on women, according to the Cleveland Clinic. 

Nerve stimulation: Another treatment is stimulation of a nerve in the ankle. “The percutaneous tibial nerve that helps the bladder function starts in the lower back and ends in the ankle,” says Dr. Kobashi. In this treatment, the doctor inserts a tiny needle into your ankle. It sends pulses to the tibial nerve to help correct signals going to your bladder. An alternative to this is a nickel-sized implant placed in the ankle. 

Surgery: If other treatments aren’t working, your doctor may suggest surgical solutions. These include: 

• Pacemakers. This small device is implanted above the bladder muscle. Small wires send signals to the nerves that control your bladder and pelvic floor. 
• Urethral sling. This form of surgery is for women. The sling is a tiny hammock-like structure placed under the urethra. It helps to close the urethra and stop urine from exiting. 
• Artificial sphincter. A sphincter is a small, water-filled silicone cuff that goes around the urethra. This is mostly used on men. When you have to urinate, you open the cuff by pumping the water out, says Dr. Kobashi. 

If occasional or frequent bladder problems are cramping your style, talk to your doctor. It’s worth checking with a urologist to find out whether current treatments can help you say goodbye to leaks. 

Additional sources: 
Age-related incontinence: National Institute on Aging; National Institute of Diabetes and Digestive and Kidney Diseases 
Menopause statistic: Menopause Review  
Prostate problems: National Institute of Diabetes and Digestive and Kidney Disorders, 
Bladder-irritating foods: National Association for Continence 
Injections: Cleveland Clinic 
Nerve stimulation: Urology Care Foundation 

H3832_8750_5MS622_24_C 

© 2023, Linkwell Health, Inc. All content owned or licensed by Linkwell Health, Inc. All rights reserved.