Urinary Incontinence: What's Normal?

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How does a normal bladder work?

When a person eats or drinks, the kidneys work to eliminate the substances the body doesn’t need and transform these waste matters into urine, which accumulates in the bladder. The bladder looks like a little bag that contracts to squeeze the urine out of the body once it’s full.

When the bladder starts to fill up, the nerves surrounding it send a message to the brain telling it to empty the bladder. During voluntary miction, the brain then sends a message to the bladder’s main muscle (the detrusor) to expulse the urine. (See the diagram.)

 

 

Don't accept being told, "It's normal at your age"

Taboo or preconceived notion?

People often believe—incorrectly—that aging brings with it urinary incontinence, and that nothing can be done about it. People who suffer from urinary incontinence are often embarrassed to talk about it. "I’m regressing to childhood; I can’t hold myself." Less than half of women who suffer from urinary incontinence talk about it with their doctors. More than half of doctors don’t ask any questions on the subject.

This taboo needs to be broken, and people who are dealing with a urinary incontinence problem need to know that they can improve their situation and even heal the problem entirely as long as they know its cause. There are various treatments available. Take the leap—talk to your doctor! He or she can help you choose the best one for you.

The taboo against urinary incontinence can lead people to isolate themselves, reduce their quality of life and self-confidence, and even lead to depression. People’s social lives suffer; they may refuse to go out, or need to plan the tiniest details ahead of time. Every move needs to be calculated. A person’s sex life may also be affected by the negative consequences this can have on their emotional and psychological well-being.

As needed, you can ask to be referred to a urinary incontinence specialist.

A normal sign of aging?

Contrary to popular belief, urinary incontinence is not part of the normal aging process. However, if people don’t exercise their muscles, they lose 1% of their muscle mass each year. This is true for all muscles, including pelvic floor muscles, which help hold back urine when the bladder is full. If these muscles get too weak, urine may leak. The good news is that you can strengthen your pelvic floor muscles by doing Kegel exercices.

With age, it’s normal to need to urinate up to twice a night, because the kidneys eliminate more at night than during the day. However, if you’re urinating more than twice a night, the situation is not normal and should be treated. You don’t need to live with urinary incontinence. Incontinence can be treated, healed and even prevented. The important thing is to talk about it! In most cases, once adequate treatment has been prescribed and followed, sufferers find their quality of life to be greatly improved.

Incontinence: an illness?

Urinary incontinence is not an illness, but rather, a symptom of a body dysfunction in the bladder, the muscles or elsewhere in the body. Between 50 and 75% of urinary incontinence cases can be healed or improved thanks to simple treatments (exercises to strengthen the pelvic floor muscles, dietary changes, medication).

Urinary incontinence options have considerably evolved in recent years. Health professionals now have numerous treatment options that can be adapted to your specific situation. Talk to your health care specialist!

Once incontinent, forever incontinent?

Certain types of urinary incontinence may be temporary, such as those related to a bladder infection, and they will usually disappear after antibiotic treatment. Others may go on for a long time, but for the most part, there are treatments to eliminate urinary incontinence or control it successfully. The sooner treatment begins, the more effective it will be.

Next: Risk Factors for Urinary Incontinence

 

We are pleased to house this series of FAQs supervised by Cara Tannenbaum, from the Centre de recherche de l’Institut universitaire de gériatrie de Montréal.

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