Avoid the Sneeze Pee

Adult Guide to Urine Incontinence

At my family medicine clinic, Beyond Primary Care, located in Ann Arbor Michigan, I see a fair number of individuals who experience urinary incontinence. Urinary incontinence is when urine leaks, from a number of causes, that becomes frequent or severe enough to be a problem. Incontinence happens in men and women. Unless I specifically ask some individuals, some may think that incontinence is an unavoidable part of getting older or a known consequence of child birth. I wanted to tell everyone that urinary incontinence can be addressed with both non-medication and medication intervention. In this guide, I talk about non-medication treatments.

Your Anatomy

The bladder is a hollow sac (like a balloon) with muscular walls. It sits behind the pelvic bone. The bladder is part of the urinary system, which includes two kidneys, two ureters, a bladder, and a urethra. The kidneys take waste and water out of your blood to make urine. The urine travels down your ureters to the bladder. When you're ready to urinate, the urine empties through the urethra.

What is Average

It sounds like kind of a lot, but, depending on how much liquid you drink, peeing roughly 8 times during the day is average. Even though it's annoying, getting up once to twice during the night is also considered normal. Most bladders hold about 2 cups of fluid (473 mL). A classic excuse among the frequent pee-ers: "I just have a small bladder!" Turns out, there's some truth to that seemingly odd refrain. Anatomically, everybody can be different, just like some people are tall and some people are short.

Turn Perception into Measurements

If you're irked by how much time you spend atop the throne, consider keeping a diary to chart your bathroom breaks. When you actually tally up your trips, what feels like a lot might be totally normal. Again, most bladders hold about 2 cups of fluid. If you're going to the bathroom frequently and producing less than that, that may not be normal.  And yes, you should actually measure. Grab a container and see if you're hitting 1.5 to 2 cups.

Existing Medications &  Other Causes

• Take a look at your existing medications. Medications may lead to incontinence. As example, diuretics (water-pills) used to treat high blood pressure can cause the kidneys to make a lot of urine really quickly. Review your medications with your doctor. 
• Diabetes: If you've ruled out other causes, there's a chance your constant peeing is due to diabetes. If your blood sugar's high, the kidneys won't be able to process all of it, and some can spill into the urine. That sugar will essentially pull more water out of you, so you'll be generating more pee. 
• Urinary Tract Infection:  Signs of an infection may include pelvic pain, increased frequency, increased urgency, and possible blood in the urine.
• Pelvic Support and Urinary Tract Problems: The pelvic organs are held in place by supportive tissues and muscles. Problems occur when these tissues are stretched, weakened, or altered by stool impaction, pregnancy, childbirth, abnormal growths, fistulas, or aging.

Treatment to Avoid the Sneeze Pee

Keep Drinking Fluids. Understandably, if you spend a lot of time thinking you have to pee, you might be inclined to dehydrate yourself just a touch. If you don't drink as much, you won't have to go as often, right? Turns out this way of thinking is bladder sabotage. When you drink less, the urine becomes more concentrated, and the more concentrated it is the more irritating it can be to the bladder, which can trigger the sensation that you have to go more often.”

Timed voids. The good news for the small bladdered is that you can train your bladder to hold more fluid. If you give into the urges too often, you are training the bladder not to hold as much (Just don't hold it so long that it starts to hurt). You could be inadvertently doing this if you've preemptively started emptying your bladder more frequently in just-in-case scenarios, like in hopes of warding off leakage, say, before a workout.To train your small bladder to bulk up, implement "timed voiding":

• Urinate every 30 minutes for two days, whether you have to go or not.
• Add 15 minutes to the regimen: Urinate every 45 minutes for two days.
• Keep adding 15 minutes to this regimen, until over time you have trained your bladder.

Hitting the (pelvic floor) gym. The stronger those down-there muscles, the easier it is to hold urine in. It’s better to learn how to use your muscles to tighten the pelvic-floor area. Yes, we're talking about Kegel exercises. If you don't already know, the exercises are performed by tightening and releasing the muscles you'd use to stop the flow of urine without moving anything else in your body. Find your pelvic muscles by tightening the rectum as if trying not to pass gas or pinching off a stool. Done best after emptying the bladder. Tighten and hold for up to 3-5 seconds, then release and relax 5 seconds. As muscles get stronger, progress to 10 seconds. Do these exercises 10-20 times a session, 3 times a day. Remember to breath normally. It may take 4-6 weeks to notice results.