Let’s Talk About Bladder Leaks: They’re More Common Than You Think

Author: Robert C. Chan, MD

Bladder leakage and urinary incontinence are subjects that rarely come up in conversations, yet maybe they should.

Approximately, one out of three women over the age of 45, and one out of every two women over 65 have stress urinary incontinence. Incontinence tends to become more common as people get older. However, it can affect all ages and both men and women.

The condition can be temporary such as with a urinary infection, or caused be ongoing such as when changes occur in the nerves or muscles around the bladder.

Wanting to call attention to these common but typically embarrassing issues, celebrities Kris Jenner, Samuel L. Jackson, and Kate Winslet have decided to share their experiences with the world.

Kate Winslet, the 43-year-old star of Titanic, shared on the U.K.’s The Graham Norton show how she suffered from a form of bladder leakage, stress urinary incontinence, associated with activities such as coughing, laughing, lifting, or running.

“I can’t jump on trampolines anymore, I wet myself,” Winslet said.

Samuel L Jackson, the star of The Avengers, Star Wars, and Pulp Fiction, was initially embarrassed to talk about his experiences, but has been quoted saying “I realized that this was a problem that millions of Americans deal with every day.”

Kris Jenner, on an episode of Keeping up with the Kardashians, has shared one of her episodes of urinary incontinence that occurred at a restaurant after Khloe Kardashian didn’t let her out of the booth to get to the bathroom.

Patients often feel embarrassed or nervous about talking about their conditions with their physicians. Often, they no longer leave their house, exercise, or go out to dinner or the movies for fear of having accidents.

What are the types of incontinence?

Stress Incontinence
This is leakage associated with activities such as lifting, coughing, sneezing, or running. Many women who have had children develop this as well as men who have had prostate surgery.

Urge Incontinence
With this type of leakage, patients complain they have a strong urge to go to the bathroom, but begin leaking before they can make it in time. It is caused by a bladder contraction that happens when patients aren’t trying to go to the bathroom.

Overflow Incontinence
This happens when the bladder fills up, doesn’t empty, and the urine overflows beyond what the bladder can hold.

How is urinary incontinence diagnosed?

Diagnosis of urinary incontinence starts with a physical exam and discussion of your health. Your liquid consumption—how much, when and what type you drink—will be important to the discussion. Many patients are asked to keep a “bladder diary” for a few days before visiting the doctor.

Other tests may include a urinalysis, a bladder stress test (if leaks occur when you cough, sneeze or laugh). Further testing may include X-rays or ultrasound, or further diagnostic testing especially if surgery is being considered.

What are some treatments for urinary incontinence?

Treatments range from conservative management to more invasive forms of therapy.

With conservative management, your physician may recommend several techniques including the use of medications, devices such as a pessary, physical therapy with Kegel exercises, and biofeedback. Using behavioral techniques to train the bladder such as holding your urine for longer periods of time between trips to the bathroom, emptying the bladder more completely, or scheduling your bathroom visits are effective treatments.

Reducing liquids, especially alcohol or caffeine. losing weight and increasing your physical activity can also help.

An array of over-the-counter "hygiene products" are also available to help you manage issues with bladder leakage or incontinence. These include pads, liners, pads, disposable underwear, and reusable underwear to absorb moisture.

If more aggressive treatment is needed, your physician may recommend sling surgery, peripheral nerve stimulation, botox injection, and bladder nerve stimulators.

If celebrities can talk about it, so can you. Seek the help you need. Don’t let your bladder stop you from living the life you want. Bladder leakage and incontinence are treatable conditions that no longer have to limit people’s lives.