Understanding the bladder
In order to understand bladder control and incontinence, it is important to understand what the bladder actually is. The bladder is just a muscular bag that contains urine, which is a waste product of digestion. The bladder is located in the pelvis (pelvic region), at the bottom of the abdomen, which is located near the pubic bone.
The bladder receives urine from the kidneys. The kidneys extract waste products from the body and mix them with water to create urine, which can then be filtered into the bladder through the ureters and passed out the body.
The bladder doesn’t actually do much apart from store urine. In fact, it doesn’t even make the urine leave the bladder! When the bladder is full, it sends signals to the brain, which telsl you that you need to go to the toilet. The muscles surround the bladder (pelvic floor), then put pressure on the bladder which allows urine to pass through the urethra, and out of the body.
What is incontinence?
Incontinence is the inability to control the functions of the bladder. Incontinence disables you from being able to stop yourself urinating. It is a common problem that affects a large number of people in the developed world. It is essentially the unintentionally passing of urine.
What types of incontinence are there?
There are five basic types of incontinence:
Stress incontinence occurs when the pelvic floor muscles that surround the bladder become weak and become unable to keep the bladders valve shut. Stress incontinence happens when extra pressure is exerted on the bladder when the kegel muscles are weakened. Therefore, patients with weak pelvic floors find themselves leaking urine during coughing, sneezing, laughing, rapid exercise and anything that causes loss of bladder control.
Urgency incontinence is when the patient has the sudden urge to go to the toilet (hence the name urgency incontinence), but is unable to get to the toilet in time. This is usually caused by damaged nerves which do not tell the brain that the toilet is needed in time. The nerves can be damaged due to a variety of problems, however the most common is scared tissue from childbirth.
Mixed incontinence is another common type of incontinence. Mixed incontinence is when urgency incontinence and stress incontinence are experienced at the same time. Having mixed incontinence is actually more common than having any single form of incontinence; however, it is worth noting that one type of incontinence is usually stronger than the other.
Fecal incontinence is similar to urinal incontinence, though it involves solid or liquid stool as opposed to urine. Fecal incontinence can be related to the excretion of gas, solid or liquid fecal matter.
Chronic Retention of Urine
Chronic retention of urine involves urinary leakage due to an inability to contain a large amount of urine. Effectively, the bladder can only hold a certain quantity of urine at any one time, and when this is exceeded, leakage occurs. This means that anyone can experience chronic retention of urine, without necessarily having a disorder. That said, it is common for people with enlarged prostates, diabetes and spinal injuries to experience a chronic retention of urine.
Getting to grips with bladder control
When we talk about bladder control problems, we are actually talking about pelvic muscle control. The reason most people have problems with incontinence is because they have weakened muscles around the pelvic floor, which controls the valve that actually keeps the urine in the bladder.
Urine control (pelvic floor control), can be increased through the use of kegel exercises and training. Equipment can also be used to enhance the success of bladder control exercises with (vaginal weights and Incontinence clamps).
If kegel exercises for men and kegel exercises for women do not work, bladder control can be increased through surgery. This involves psychically tightening the pelvic floor by removing segments of muscle. This is usually not done unless the patient is absolutely unable to achieve positive results through natural exercises.Medical treatment can also be used, however it is usually used to combat an overactive bladder, if the incontinence is a by product or a larger issue. An example of this is medication for depression (depression can sometimes cause incontinence). Medication is usually advised after all other methods, such as kegel exercises , fail.