Bladder problems can seriously affect daily life.

Treatment and techniques to help control the flow of urine

Bladder leakage, frequent urination, sudden urges to pee and waking up at night are common issues that can affect anyone — men or women, young or old. Even though many people experience these problems, they are not a normal part of aging, and effective treatments are available.

There are several different types of bladder leakage, also known as urinary incontinence (UI):

1. Stress incontinence: Leakage happens when you cough, sneeze, laugh, run or lift something heavy.

2. Urge incontinence: Leakage occurs when you suddenly feel the need to pee but can’t make it to the bathroom in time.

3. Mixed incontinence: A combination of both stress and urge incontinence. Usually, one type is more bothersome.

4. Functional incontinence: Occurs when someone has trouble getting to or using the toilet in time — for example, because of limited hand strength or mobility problems.

5. Overactive bladder: This includes a strong, frequent urge to urinate (sometimes with leakage), going to the bathroom often and waking up at night to urinate (nocturia).

These bladder problems can seriously affect daily life. People may feel embarrassed, limit physical activity, drink less fluid or avoid social events out of fear of leaking. This can lead to less exercise, weaker muscles and even isolation. Getting up multiple times at night to pee also increases the risk of falls, especially in older adults.

How Pelvic Floor Physical Therapy Can Help

Pelvic floor physical therapy is a first-line, non-surgical treatment that focuses on improving how the pelvic floor muscles work.

These muscles support your bladder and help control the flow of urine.

A physical therapist can:

1. Examine your pelvic floor muscles to see if they are weak or too tight.

2. Design an exercise program to either strengthen or relax the muscles as needed.

3. Help retrain your bladder with bladder diaries that track how often you urinate and what you drink.

4. Check your bowel habits, as constipation can worsen bladder issues.

5. Assess your overall strength and flexibility, since your lower body also plays a role in bladder control.

What’s Normal for Bladder Habits

1. Frequency: Most people should urinate about six to eight times per day, depending on how much they drink.

2. Nighttime: Getting up once per night to pee can be normal, especially during late pregnancy or with older age.

3. Fluids: Don’t cut back too much on fluids; that can make your urine more concentrated and cause burning.

4. Avoid irritants: Drinks with caffeine, carbonation or artificial sweeteners can irritate the bladder and worsen symptoms.

5. Don’t go “just in case”: Going too often trains your bladder to feel full sooner.

6. Toileting posture: Sitting fully on the toilet (not hovering) helps your muscles relax, allowing your bladder to empty completely.

Helpful Techniques and Treatments

1. For stress incontinence, you can learn to tighten your pelvic floor muscles just before coughing or sneezing. Practicing this regularly helps you use the muscles when needed.

2. For urge or overactive bladder, treatment often starts with a bladder diary, followed by timed voiding and urge control techniques to help retrain your bladder.

3. Some people benefit from electrical stimulation — gentle electrical impulses over the ankle or lower back that help calm bladder nerves. This can be done at home or in a clinic.

4. Multiple medications can help with overactive bladder symptoms, which doctors may suggest.

5. In more severe cases, doctors may recommend in-office procedures or implanted devices to help manage nerve signals to the bladder.

Takeaway

Bladder leakage and urgency are common but treatable problems. With the right approach — including pelvic floor therapy, healthy bladder habits, and, if needed, medical treatments — most people can regain control and improve their quality of life.

There is currently a research study enrolling women over the age of 60 who experience symptoms of urinary urgency with or without incontinence, urinary frequency and/or nocturia. If you are interested in determining if you are eligible for this study, please get in touch with the author at Amanda.mahoney@lsuhs.edu or by calling (318)813-2970.