General Information about Bladder Control for Women

Why Talk About Bladder Control?

Women of all ages have bladder control problems. Some younger women find they can't hold their urine after having a baby. Others have problems when they stop having periods. Many women over the age of 75 also have bladder control problems.

You may feel ashamed about bladder control problems. Remember that it's a medical problem and it's not your fault. Millions of women have the same problem.

Don't believe people who tell you that urine leakage is normal. It isn't. Most of the time it can be improved.

Your health care team can help you. Nearly everyone with a bladder control problem can be helped. Call your clinic and find out how.

Where Can You Go for Help?

You can do many things to help improve your bladder control. Talk to your family doctor or nurse. If you have a more difficult case, you may need to see a urologist (yoor-ALL-uh-jist). Urologists are experts in bladder and urine problems. A gynecologist (guy-nuh-CALL-uh-jist) is a doctor who treats problems of the female system. Your gynecologist can also help you with bladder control. Your doctor might also want you to see a urogynecologist (YOOR-oh-guy-nuh-CALL-uh-jist). Urogynecologists treat women's bladder and urine problems.

You can also get help from a urology or continence nurse. Visiting home nurses can help you learn about bladder control. Some physical therapists help people with pelvic muscle exercise programs. Check with your insurance plan about payment for these services. You may need a referral from your regular doctor.

If you feel shy about calling a doctor or nurse, maybe a support group can help you. Some groups will talk to you on their toll free number. Others have free or inexpensive brochures and videos about bladder control.

What Does the Doctor Need to Know?

You will need to keep a record. Try to write down the times when you go to the bathroom. Write down when you have accidents, too. Do this for a day or more. This record is called a bladder control diary. Diaries help your doctor or nurse learn the cause of your problem.

What Your Doctor Needs to Know

I take these prescription medicines:

_______________________________________________

_______________________________________________

_______________________________________________

I take these over-the-counter drugs (such as Tylenol, aspirin, or Maalox):

_______________________________________________

_______________________________________________

_______________________________________________

If you take more medicines, please list them on a separate paper.

I started having bladder trouble:

___ recently

___1 to 2 years ago

___ years ago

Number of babies I have had:________

Dates:_________________________________________

My periods stopped (menopause).

Date:__________________________________________

I recently had an operation.

Date:__________________________________________

Type of operation:________________________________

I recently hurt myself or have been sick.

Date: __________________________________________

Type of injury or illness:____________________________

I recently had a bladder (urinary tract) infection.

Date: _________________________________________

I am often constipated. __yes __no

I have pain or burning feelings when going to the toilet. __yes __no

I often have a really strong urge to go to the toilet right away. __yes __no

Sometimes my bladder feels full, even after I go to the toilet. __yes __no

I go to the toilet often, but very little urine comes out. __yes __no

I don't go out with friends/family because I worry about leaking urine. __yes __no

The first thing I do at new places is check the bathroom location. __yes __no

I worry about being put in a nursing home because of bladder control problems. __yes __no

I have (or had) these medical problems:

__Cancer

__Constipation

__Crippling arthritis

__Diabetes

__Depression

__Diverticulitis

__Interstitial cystitis

__Multiple sclerosis

__Spinal cord injury

__Stroke

__Urinary infection

__I smoke cigarettes.

Will The Doctor Do Tests?

You will probably have a physical exam. The exam can show the reasons for your bladder control problem. First, your health care team will look for a simple cause. It could be an infection in the bladder or urethra. This can be treated easily. The reason for your problem may be harder to find. Then, the doctor or nurse may want to do some tests:

• Check to see how well the bladder muscles are doing their jobs.
• Take samples of urine and blood for tests.
• Look for something blocking the urine flow--like a stone, a growth, or hard bowel movement or stool.
• Take pictures of your bladder, using special machines.

What Does The Bladder Control System Look Like?

Most of your bladder control system lies inside your pelvis. Stand with your hands on your hips. The bones under your hands are the pelvic bones. Your pelvis is shaped like a big bowl. The bottom of this "bowl" is the area between your legs. The muscles across this area are the pelvic floor muscles.

Your bladder is another muscle. It is a balloon-shaped organ inside your pelvis, just below your belly button. Your pelvic floor muscles should be strong and tight to hold up your bladder in its proper place.

Your bladder should stay relaxed when it is full of urine. But, when you go to the bathroom, the bladder muscle should tighten. This squeezes urine out of the bladder.

The sphincter (SFINK-tur) muscles are two muscles that surround the tube that carries urine from your bladder down to an opening in front of the vagina. The tube is called the urethra (yoo-REE-thrah). Urine leaves your body through this tube.

The sphincters keep the urethra closed by squeezing like tight rubber bands. The pelvic floor muscles also help keep the urethra closed. Urine stays inside your body when the pelvic floor and sphincter muscles are tight and the bladder is relaxed.

When the bladder is full, nerves in your bladder signal the brain. That's when you get the urge to go to the bathroom. Once you reach the toilet, your brain sends a message down to the sphincter and pelvic floor muscles. It tells them to relax. The brain signal also tells the bladder muscles to tighten up. That squeezes urine out of the bladder.

Bladder control means you urinate only when you want to. For good bladder control, all parts of your system must work together.

• Pelvic muscles must hold up the bladder and urethra.
• Sphincter muscles must open and shut the urethra.
• Nerves must control the muscles of the bladder and pelvic floor.

Points to Remember about Bladder Control in Women

• Many women have bladder control problems.
• Bladder control problems do not have to be a normal part of aging.
• Many medical conditions can cause bladder problems.
• Try not to let embarrassment about bladder control problems keep you from talking to your health care team.
• Most cases of poor bladder control can be improved greatly.
• Ask your health care team for help.

Each year, Medical College of Wisconsin physicians care for more than 180,000 patients, representing nearly 500,000 patient visits. Medical College physicians practice at Children's Hospital of Wisconsin, Froedtert Memorial Lutheran Hospital, the Milwaukee VA Medical Center, and many other hospitals and clinics in Milwaukee and southeastern Wisconsin.