Over 3.5 million Canadians live with some form of urinary incontinence, which is the involuntary leakage of urine. Despite its prevalence, experts say there is still enormous stigma around this condition, making many people feel embarrassed to reach out for help. At the last Sunnybrook Speaker Series, Managing Incontinence, Nurse Practitioner Stephanie Chadwick talked about contributing factors and what treatments are available.
Incontinence can have a huge impact on most aspects of daily living, from social interactions to intimacy. Chadwick says there are many possible contributing factors, including pregnancy, menopause, obesity and constipation. Some medical conditions can also increase the risk, including diabetes, certain cancers and surgeries, and diseases like Parkinson’s disease and MS.
If you are living with incontinence, she says it’s important to talk to your doctor. They will consider factors like your medical history, general health, current medications and lifestyle before discussing possible next steps. It’s key to understanding the underlying cause before recommending possible treatment strategies.
Chadwick says that minimally invasive approaches are often the best place to start.
A well-balanced diet that promotes regularity is always important, and especially so if you are living with urinary incontinence. Constipation can confuse nerves that trigger a feeling of fullness, making people feel the need to void. Drink adequate fluids, but Chadwick advises to steer clear of beverages and foods that contain caffeine, artificial sweeteners and citrus fruits, which can over stimulate the bladder.
Other things to avoid include alcohol, which can have a diuretic effect and lead to the feeling of having to go more often. Smoking can cause bladder inflammation, making people feel like they have to go more often and urgently, so cessation is beneficial.
Chadwick says keeping a bladder diary will help track possible triggers and is a good tool to bring to doctor’s visits. Retraining strategies, like trying not to go to the washroom with the first urge, may be recommended. Bladder training on schedule, timing from two to three hours and then working for a longer duration of time, may gradually increase the amount of urine that can be held comfortably. Pelvic floor exercises have also been shown to strengthen the muscles around the pelvic floor and urethra, and improve ligaments. It is important to have training by a professional in order to know the type of pelvic floor exercise you may require.
Chadwick says nonsurgical vaginal pessaries, which are small ring-like devices inserted into the upper vagina, can help offer support with female prolapse and stress incontinence. As well, if these approaches are unsuccessful, she says there are many other treatment options to discuss with your doctor. Menopausal women should always talk with their health practitioner regarding maintaining vaginal integrity.
To learn more about these approaches, as well as different types of incontinence, watch the Sunnybrook Speaker Series below: