Bladder Leakage

Leaking urine is more common than you might think—there are ways to cope with light bladder leakage.

Maybe you’re on a jog or simply sneezing and you feel a small amount of urine dribble out—you can’t stop it. What is happening? Could this be incontinence? After all, you only had one vaginal birth—you might be asking yourself, “Should I be leaking urine at such a young age?”
Truth is light bladder leakage can happen for women at any age, regardless of previous pregnancies or births, even if you’ve had cesarean.

What is light bladder leakage?

Light bladder leakage (LBL) is urine loss you can’t control, which is called incontinence. 1 in 4 women experience it, and the 2 most common types are stress incontinence and urge incontinence—some women have both types.

Stress incontinence is leaking urine during activities that put pressure on your bladder like coughing, running, jumping or sneezing. It happens when your pelvic floor muscles—the muscles that support your bladder—are weak, such as from pregnancy, previous vaginal birth, or being obese or overweight. Still, it can happen without any of these risk factors.

Urge incontinence is the frequent, sudden need to pee that often causes bladder contractions and leaking small or moderate amounts of urine. Caffeine, alcohol, drinking too much water and medications like diuretics (water pills) or neurological conditions can irritate your bladder, leading to urge incontinence. Maybe you’ve heard it called overactive bladder.

What can I do?

Please don’t ever be embarrassed by light bladder leakage, it’s common and you’re not alone. Talk to your nurse about it, even if they don’t ask. You can build up your pelvic floor to prevent light bladder leakage.

Pelvic Floor Strength

During a pelvic examination, your nurse or healthcare provider may ask you to squeeze your pelvic floor muscles; they want to check their tone—or how much your muscles resist stretching when they’re resting. Since your whole pelvic floor is supported by muscle, you can strengthen it. Maintaining good pelvic floor muscle tone is critical to preventing or improving bladder leakage. You’re not alone if you’re not sure how to contract your pelvic floor.

Pelvic floor exercises are the easiest way to strengthen these muscles, as are Pilates exercises, which strengthen your core. According to the Mayo Clinic, perfecting pelvic floor exercises is key to making bladder leakage a thing of the past.

Many of us forget to do daily pelvic floor exercises, so it’s helpful to create mental reminders—like doing a set at every red traffic light or during a TV or radio commercial. At first, squeezing these muscles may feel odd, but you’ll get used to it. And it’s safe and important to keep your pelvic floor strong during pregnancy.

Weight loss to reduce leaking

If you’re overweight or obese, just losing 5 to 10 pounds can relieve some abdominal pressure on your bladder. Maybe you’ve recently had a baby and noticed that the leaking has diminished as you’ve lost the baby weight. Remember to reduce the amount of bladder irritants you’re taking in, such as caffeine or alcohol each day, and don’t let your bladder get too full—even on busy days.

Physical therapy for light bladder leaking

So what if you’ve regularly done your pelvic floor exercises, lost some weight, and curbed the caffeine but the bladder leakage isn’t getting any better? You should definitely talk to your nurse because for some women referral to a physical therapist (PT) who specializes in pelvic floor/women’s health might be necessary. Yes, there are actually PTs who specialize in this important muscle group!

If you need this specialized PT, what should you expect?  First, you’ll review your health history: how many pregnancies you’ve had, how much your babies weighed, what makes the leakage better or worse and if you’re taking any medicines that could irritate your bladder.

The PT will evaluate your posture, back and hips and may ask your permission to do an internal exam to better check your tone, but this won’t involve any equipment like a speculum. You’ll probably be given a specialized treatment plan of home exercises and be asked to return for follow up evaluation and care.

If these efforts don’t seem to help, you may need a urogynecologist—a gynecologist with a subspecialty in pelvic floor medicine. This type of specialist may offer other treatments including surgery but not all women will need surgery for better bladder health.

Susan Peck, MSN, APN, is an expert adviser to Healthy Mom&Baby.

Perfecting pelvic floor exercises is key to making bladder leakage a thing of the past.

Pelvic Floor Power!

If you’re doing pelvic floor exercises correctly to minimize bladder leakage, no one will know. Make it your secret exercise!

• Find the right muscles. To identify your pelvic floor muscles, stop peeing midstream. If you succeed, you’ve got the right muscles. Once you’ve identified your pelvic floor muscles, you can do the exercises in any position, although you might find it easiest to do them lying down at first.
• Perfect your technique. Tighten your pelvic floor muscles, hold the contraction for 5 seconds, and then relax for 5 seconds. Try it 4 or 5 times in a row. Work up to keeping the muscles contracted for 10 seconds at a time, relaxing for 10 seconds between contractions.
• Maintain your focus. For best results, focus on tightening only your pelvic floor muscles. Be careful not to flex the muscles in your abdomen, thighs or buttocks. Avoid holding your breath. Instead, breathe freely during the exercises.
• Aim for at least 3 sets of 10 repetitions a day.