Bladder Control Training
Bladder control training is one of the first courses of treatment your doctor will prescribe for bladder control problems such as stress, urge, functional and overflow incontinence. Bladder control training is a behavioral method of treatment that gradually allows you to hold your urine for longer and longer periods of time to prevent emergencies and urinary leakage. Following bladder control training, patients are generally able to go longer periods of time between trips to the bathroom, can hold more urine in the bladder and have more control over the urge to urinate.
The three primary methods of bladder control training are:
- Scheduled Bathroom Visits: This is known as timed voiding, and is the first step in bladder control training is tracking your daily trips to the bathroom in a diary. Based on this information, the first step is to schedule bathroom visits adding 15 minutes to each visit. For example, if you visit the bathroom every hour, you'll schedule each visit for 15 minutes after the hour to train your body to hold urine longer. These intervals gradually increase as you get better at retaining urine.
- Delaying Urination: Another training method is delaying urination. When you feel the urge to urinate, hold it for five more minutes. Gradually increase this amount of time to 10 minutes or more, until you can go three to four hours without needing to visit the restroom.
- Kegel Exercises: Kegel exercises strengthen the muscles in the bladder and pelvic floor, helping you control urine flow and stop it altogether. Squeeze the muscles you use to stop urine flow for five seconds, then release for five, performing three sets of 10 exercises each day. Eventually your muscles will strengthen to allow 10-second intervals, helping you control urine flow much more effectively.
There are often as many questions as answers when it comes to holistic treatments for bladder control problems. A number of herbs and remedies have been traditionally used for bladder control problems, but for many, the science is still out about their effectiveness. Always consult your doctor before trying herbal remedies which may not be right for you or may conflict with other medications you're taking.
Some of the most commonly used holistic therapies include:
Saw Palmetto: Saw palmetto is a popular holistic treatment for bladder control problems with several studies measuring its effect on urinary symptoms. Saw palmetto has anti-inflammatory properties and effects testosterone levels, which can help men experiencing problems related to an enlarged prostate.
Gosha-jinki-gan: One of the most researched herbal remedies for bladder control problems is gosha-jinki-gan, studies out of Japan found that gosha-jinki-gan improved urinary urgency, frequency, nighttime urination (enuresis) and quality of life for patients with overactive bladder. Based on animal studies, researchers believe gosha-jinki-gan increases bladder capacity and reduces the number of bladder contractions due to its effects on the nervous system.
Buchu: Buchu has been used for many years as a remedy for a number of health problems. Buchu is said to alleviate symptoms of urinary tract infections and OAB, though it could be that buchu tea is caffeine free, which on its own can help alleviate symptoms of bladder control problems.
Cleavers: Cleavers tea is marketing as a detoxifying and lymphatic support product and has been known to coat the inside of the bladder wall, protecting against irritation and lessening symptoms of OAB.
Cornsilk: The strands of silk you pick off corn before eating is also available in supplement form. Corn silk tea is purported to ease symptoms of urinary tract infections and OAB.
Horsetail: The ancient horsetail plant is a mild diuretic, which can increase urine flow and actually worsen symptoms of OAB, but also has anti-inflammatory properties that can help lessen symptoms of incontinence.
Minimally Invasive Surgical Treatment
Minimally invasive surgical procedures can be used to treat common bladder control problems like stress incontinence, some bladder issues and certain prostate conditions. Consult your doctor to learn which treatment might be best for your situation.
Sling and Suspension Procedures
Your doctor may opt for a suburethral sling procedure to help you deal with symptoms associated with stress incontinence. The sling uses a small strip of your own tissue to lift and support the urethra in a more anatomical position, exerting pressure on the urethra and helping prevent urinary leakage.
Tension Free Vaginal Tape (TVT)
Tension Free Vaginal Tape (TVT) is a minimally invasive surgical procedure suitable for some women with stress incontinence. The purpose of a TVT procedure is to create an artificial support at the end of the urethra to keep it closed, preventing urinary leakage. A sling is inserted through the vagina and placed under the urethra to lift it into its anatomical position, allowing the urethra to remain closed.
TVT Obturator System (TVTO)
The TVT Obturator System is another form of treatment for female stress urinary incontinence using an "inside-out" technique that passes a mesh device from a small incision in the vagina out to small incisions in the thigh folds. The TVT Obturator System works similarly to the TVT procedure but reduces the potential for urethral and bladder injury.
Bladder Neck Suspension
Bladder neck suspension procedures reinforce the urethra and bladder neck, compressing the urethra and helping to prevent urinary leakage. The surgeon makes a small incision in your lower abdomen and stitches the bladder neck to a ligament or cartilage near the pubic bone. Recovery time is generally longer than sling procedures.
Traditional Laparoscopic Surgery
Laparoscopic surgery can be used to alleviate certain symptoms of bladder control problems or gather additional information by getting a closer look at the problem. During a minimally invasive laparoscopic surgery, the surgeon makes a series of small incisions through which they control long-handled surgical instruments that project images from within the patient, enabling the surgeon to carry out precise procedures
Similar to laparoscopic surgery, robotic surgery is performed through a number of small incisions in the patient, projecting high-definition 3D images to the surgeon and allowing them to operate special wristed instruments that bend and rotate far more effectively than the human wrist. Surgeons using robotic techniques have enhanced vision, precision dexterity and control.
InterStim® (Sacral Nerve Stimulation)
InterStim® Therapy is a proven treatment for overactive bladder, helping control the bladder, sphincter and pelvic floor. A small pacemaker-like electrode adjacent to the sacral nerve that helps stimulate the nerve and help control the bladder, sphincter and pelvic floor. The electrode is externalized and patients monitor their urinary urgency, frequency and pain for two weeks. If the symptoms are at least 50 percent improved, a stopwatch-size power generator is implanted in the upper part of the buttock and connected to the previously-placed lead. Beaumont is the No. 1 implanting hospital in the country of InterStim sacral nerve simulators for OAB.
InterStim® (Pudendal Nerve Stimulation)
In addition to stimulating the sacral nerve, Kenneth Peters, M.D., chief of urology at Beaumont, Royal Oak, developed pudendal nerve stimulation using the InterStim device. Our studies have demonstrated pudendal stimulation to be superior to sacral stimulation for voiding dysfunction and pelvic pain.
Though bladder control problems are quite common, the subject can be embarrassing to talk to friends and family about or bring up with your doctor. Treatment options can make an immediate impact on improving your quality of life, but unless you seek help, you'll find yourself alone trying to hide your secret.
Along with surgery, medication and lifestyle treatments, psychological counseling has proven results for helping patients deal with managing symptoms of bladder control problems, learning to control their conditions rather than letting them control you and having someone to talk to about everyday stress of not being in full control of your body.
Beaumont health professionals are trained to help you seek out appropriate treatments for bladder control problems and walk you through every step of the way, from preparing for treatment, sticking to lifestyle changes or helping you deal with any obstacles along the way.