Guest Post: "Living with bladder leakage? You’re not alone"

[RhiannonEMumsnet]

Do you ever experience bladder leakage? Although millions of people, particularly women, are affected, it’s not something we tend to talk about.

If you’ve ever laughed, sneezed, or exercised and felt a little leak, you’re far from alone. Bladder leakage, also known as urinary incontinence, is when you involuntarily lose urine and it affects 1 in 3 women in the UK. It’s common, but that doesn’t mean you have to just put up with it.

Isn’t it just a normal part of ageing?

Bladder leakage can happen for a number of reasons. It can be caused by anxiety, childbirth, disabilities, long-term illnesses, as a result of issues such as Urinary Tract Infections, and, although it’s often not talked about, it can also happen as a result of the menopause.

As a Urology Nurse, I want you to know that you don’t have to suffer alone. It’s not just a normal part of ageing that you need to put up with. Help is available. Whether your leaks are occasional or more frequent, you should speak to your healthcare professional for support. Specialists, including continence nurses and physiotherapists, can make the world of difference to those affected. People can often get back to enjoying their life with the help of a manageable plan.

Women’s experiences of bladder leakage

September is Urology Awareness Month, and this year The Urology Foundation spent the month focusing on empowering women to manage bladder leakage confidently and seek the help they deserve. As part of this campaign, we commissioned a survey of 1,000 women in the UK who have experienced bladder leakage and we found that mental health can take a real knock. Many people delay seeking help, feeling embarrassed or assuming they already know the reason for their leaks:

• 72% of women diagnosed with bladder leakage say their mental health and emotional wellbeing has suffered due to their condition
• 81% of women experiencing bladder leakage avoid activities they previously enjoyed including taking long car journeys, walking, camping and trekking and running, cycling or exercising outdoors
• One in three women surveyed (36%) will not leave the house without knowing where the toilets are located
• 7 in 10 women (71%) questioned have not received a formal diagnosis

But leakage should never be accepted as ‘just part of life.’ Finding out why it’s happening is the first step towards change and with the right support and treatment, people can regain control and live more freely again.

Get the support you need

If you’re living with bladder leakage, or know someone who is, visit The Urology Foundation’s website for information and support.

Top tips for managing bladder leakage

In aid of Urology Awareness Month this September, we’re sharing 5 Top Tips to help you take control of your leakage while you await investigation or treatment from your healthcare professional:

1. Pack the right pants - confidence starts underneath
Absorbent underwear and pads have come a long way - breathable, discreet and odour controlling. Consider the type, size and severity of leaks you experience to find a pad or pants with the right absorbency and features for you. There are many types available now in supermarkets, pharmacies and online. Try different products to prioritise comfort, especially if you have sensitive skin. Keep a spare pair of pants or pads in your bag for peace of mind.

2. Sip smart – stay hydrated, not harassed
Drink regularly to avoid bladder irritation, but try cutting down on caffeine, alcohol, and fizzy drinks before heading out - they can make symptoms of an overactive bladder worse and increase the risk of leaks.

3. Plan ahead – know where the toilets are
When out or away, check toilet locations in advance. Download a toilet finder app and consider a RADAR key or toilet access card for peace of mind. The ‘Need to Pee’ card from The Urology Foundation can also help explain your situation discreetly.

4. Stay active - with support if you need it
Gentle movement helps bladder and bowel health. If you leak when exercising (stress incontinence), ask your healthcare professional about internal bladder support devices that can help support the bladder and pelvic floor when you exercise.

5. Squeeze daily - your pelvic floor is powerful
Pelvic floor exercises help control leaks. Try short daily squeezes while brushing your teeth, waiting for the kettle, or sitting on a train. It all adds up!

Remember

If you’re leaking urine, find out why. It’s not just age or childbirth. There could be a fixable reason, and help is out there. Asking why is the first step toward finding a solution.

It’s not always easy to talk about bladder problems but you’re not alone. Healthcare professionals hear this every day and a simple conversation could be the start of getting the right support.

As we bring this year’s Urology Awareness Month to a close, let’s break the stigma and start talking about bladder leakage.

For more resources and support, visit The Urology Foundation’s website.

If you experience Urinary Tract Infections you can also visit our Nurse-led UTI Information Service and Helpline.

For information on how to do pelvic floor exercises, see this helpful guide.

Helen will be returning to answer questions so if there is something you'd like to ask then please do post below.

Is it normal to wee then have to go back to the loo again soon after to wee again? Sometimes I experience a small leak. Is there anything I should be doing or is this normal?

BP meds can have an effect on urge incontinence and volume- are there better BP meds than others?

Mine is more like a deluge than a little leak. I have a constant cough now due to cancer and my bladder incontinence is much worse. Will pelvic floor exercises help with this or is there anything else you can suggest?

Hello, @Mumofthreee123. It’s quite common to feel like you need to wee again soon after going, and it can happen for several reasons. Sometimes the bladder doesn’t empty fully, or it becomes a little sensitive or overactive, so even a small amount of urine left behind can make you feel you need to go again.
It’s not usually a sign of anything serious, but it’s worth paying attention to, especially if it’s new or happening often. Drinking a lot of caffeine or fizzy drinks, going “just in case,” or rushing when you wee can all make the bladder more sensitive over time.

You can try

• Taking your time on the toilet - don’t rush, and try gently leaning forward at the end to help the bladder empty fully.
• The 'double void technique' can help. Wee - wait and count to 10 - wee again. Those extra drops obtained can make a difference
• Pelvic floor exercises - strengthening these muscles can improve bladder control and help prevent urgency or leakage after you wee
• Avoiding caffeine and fizzy drinks for a week or two to see if it helps
• Keeping a note of how often you go and what you drink — a bladder diary can help spot patterns. The Urology Foundation has a downloadable bladder diary available at the following link: https://www.theurologyfoundation.org/app/uploads/2024/01/Bladder-diary.pdf

If it continues, or if you notice pain, burning, blood in your urine, or you’re getting up several times at night, it’s best to speak with your GP or nurse. They can check for infection, bladder irritation, and may do a simple ultrasound scan to see if your bladder is emptying fully. Hope that helps.

Hello @steamingin. Some blood pressure medicines can have an effect on the bladder.

• Water tablets (also called diuretics) can make you wee more often - which can worsen urgency or leakage, especially if you already have bladder symptoms.
• Alpha-blockers (used in some men for prostate symptoms and sometimes for blood pressure) can relax the bladder outlet a bit too much, leading to leaks.
• On the other hand, some blood pressure medicines are a bit kinder on the bladder.

Medicines called ACE inhibitors or ARBs (that’s short for angiotensin receptor blockers) are often more bladder-friendly. They don’t tend to increase how much or how often you wee.

If you’ve noticed your bladder symptoms started or got worse after beginning a new blood pressure tablet, don’t stop taking it, but do mention it to your GP or nurse. There may be another option that suits you better. Hope that helps.

Hello, @saveforthat - I’m really sorry to hear you’re dealing with that - a constant cough can put a lot of pressure on the bladder, so it’s understandable that your leakage has worsened. Pelvic floor exercises can still be helpful, even when the leakage feels heavy, as they strengthen the muscles that support your bladder and help them respond better when you cough.

It’s worth asking for a referral to a pelvic health physiotherapist or continence specialist nurse. They can check how your pelvic floor is working, make sure you’re doing the exercises correctly, and discuss other options if needed.
If exercises alone don’t improve things, there are simple, minimally invasive treatments that can help reduce leakage by supporting the urethra and improving closure. It’s worth chatting to your GP about a possible referral to a continence or urogynaecology (urogynae) clinic, where you can talk through these options and find what’s right for you

In the meantime, using continence pads or washable underwear can help you stay comfortable and confident while you explore longer-term options with your healthcare team. You can also ask for a continence assessment via your GP which is often carried out in the community by a district nurse or continence advisor. They can help review your bladder symptoms, offer practical advice, and arrange continence pad provision according to your needs. I hope this helps.