Bladder Weakness

People tend to find urinary incontinence (bladder weakness) mortifying even though it is common and can often be cured or better controlled.

The two most common types of bladder weakness are stress incontinence - where you leak small amounts of urine when you sneeze, cough, carry something heavy or laugh, and urge incontinence (or an ‘overactive bladder’) where you get a sudden urge to wee but don’t make the toilet in time.

Symptoms:

What causes bladder weakness?

Urine is stored in our bladder until we feel the need to go to the toilet. At this point our pelvic floor muscles - the muscles we use to control the flow of urine - relax to allow a valve in the bladder (the sphincter) to open to release the urine. At the same time, muscles in the wall of the bladder also contract to help push the urine out.

Sometimes the pelvic floor muscles become damaged or weakened (often as a result of childbirth, the menopause or following prostate surgery). If this is the case then urine can leak out whenever pressure is put on the bladder, such as when you cough or sneeze. This is what happens during stress incontinence.

With urge incontinence it’s the muscles in the bladder walls that fail us. They contract involuntarily overcoming resistance from the pelvic floor muscles and sphincter to force out a large amount of urine. It’s not entirely known why this happens although it may due to an infection or nerve damage following a stroke or spinal injury.

How is bladder weakness treated?

Your GP can diagnose urinary incontinence, determine the underlying cause and suggest remedies.

Solutions may include making lifestyle changes such as losing weight, reducing caffeine intake and exercising your pelvic floor muscles. Pelvic floor exercises involve squeezing these muscles several times a day to increase their strength. There are also devices you can use such as a vaginal cone to give the pelvic floor a greater workout. Exercising alone may be enough to resolve the problem.

Bladder training may also be recommended whereby you learn to increase the length of time before passing urine.

If these measures are not effective, medication may be offered or sometimes surgery.