Photo: Getty Images
Avoiding voiding trouble
Most people take bladder control for granteduntil it's gone. But for about a third of people ages 30 to 70, incontinence is a big issue.
"Urinary incontinence is embarrassing and isolating," says Shanna Atnip, a nurse practitioner at Parkland Health and Hospital System, in Dallas, and leader of the Society of Urologic Nurses and Associates Continence Special Interest Group. "People may stop participating in activities they like to do, which can even lead to obesity."
But there are steps you can take to keep your bladder healthy and minimize trouble if you do have incontinence.
Keep a healthy weight
"The heavier you are, the more weight presses on the bladder," says Jill Maura Rabin, MD, head of urogynecology at Long Island Jewish Medical Center, in New Hyde Park, N.Y., and coauthor with Gail Stein of Mind Over Bladder.
Getting adequate exercise and eating a moderate diet full of fresh fruits and vegetables can help prevent incontinence. "Everything that you do to maintain normal health is also important for bladder health," says Atnip.
Photo: Getty Images
Do Kegel exercises
Best known for their benefits in the bedroom, Kegels involve squeezing and relaxing the muscles of the pelvic floor, which connects via nerves to the bladder. Kegels are a good way to maintain lifelong bladder control.
"It is especially important to strengthen your pelvic floor muscles before you have children, and then in between your children," says Dr. Rabin, noting that childbirth can damage the natural support for the bladder and urethra.
It's a good idea for men and women, whether young or old, to practice Kegels routinely, says Atnip.
Use caution with medication
There are at least 300 different medications that can actually cause or worsen incontinence, from diuretics to opioids, says Dr. Rabin. Generally, this side effect isn’t enough to stop taking a prescribed medication.
However, it’s worth asking your doctor if there is a different medication that might be easier on your bladder, Dr. Rabin says.
Watch what you drink
Beer, coffee, tea, and sodaor most anything containing alcohol or caffeinecan increase bladder activity and lead to leakage. Moderation is key.
"A lot of people drink too much liquid, which is going to make anybody go to the bathroom a lot," says Dr. Rabin.
You also don’t want to drink too little, she adds, as this can lead to concentrated urine and constipation; both can irritate the bladder and cause incontinence. A good rule of thumb is to consume 9 cups of liquid each day (about 2 liters). All liquidsincluding water, soups, and juice drinkscount, Dr. Rabin notes.
Avoid irritating foods
Some foods can worsen incontinence in certain people. Watch out for chocolate (another source of caffeine), as well as spicy or acidic foods like tomatoes and citrus fruits, says Dr. Rabin, as these are common irritants to the urinary tract.
To identify potential culprits, Dr. Rabin suggests eliminating one type of food every two to three weeks to see if your symptoms improve.
Not only can smoking increase the risk of bladder cancer over the long term, but cigarette smoke and nicotine also act as immediate bladder irritants, notes Atnip. This can trigger the bladder to dump urine.
Dr. Rabin adds that the chronic cough associated with smoking can also lead to accidental leakage.
Protect yourself from UTIs
Urinary tract infections (UTIs) can cause temporary bouts of incontinence because the bacteria that commonly invade the bladder weaken the muscles in the urethra, says Dr. Rabin. A UTI will not trigger incontinence for most people, but it can make a difference if you are incontinence prone, she adds.
Empty your bladder before and after sex to cut your risk of UTIs.
Drink cranberry juice, particularly when you first notice symptoms, to limit bacterial growth in the urinary tract. But don't drink too much, warns Atnip. The acid content may actually exacerbate incontinence.
Weigh the risks and benefits of treatment
In men, the prostate gland is located just below the bladder, encircling the urethra. Since the gland enlarges in almost all men with age, it can have a profound effect on urinary health. Fortunately, there are a variety of treatments for an enlarged prostate.
Incontinence is also a common side effect of prostate cancer treatment. However, there are some treatments that are less likely to cause incontinence than others, and most patients regain urinary control. Finding an experienced surgeon can help lower the risk.
And men who do develop problems can benefit from Kegels, notes Atnip.
Keeping the bowels running smoothly with a healthy intake of fiber and fluids can support the neighboring bladder too.
“A full rectum puts pressure on the bladder and causes the need to void more frequently and urgently,” says Atnip.
Consider childbirth options
Vaginal delivery is a common cause of incontinence, but many factors affect your risk. (There have been efforts to find out if cesarean births are less likely to be a problem, says Atnip, but the evidence is inconclusive).
“We do know that the use of forceps can be traumatic to the whole perineal area,” she adds. “And women who have had more children are also at an increased risk for incontinenceat least until menopause, when the risk among women evens out.”
Research also indicates that vacuum extraction and episiotomy (a small incision between the vagina and anus) should be avoided to protect the pelvic floor muscles.