Bladder Problems? Do Kegels

Bladder Problems? Do Kegels

What embarrassing health secret do teen athletes, guys in their 40s to 90s, middle-age women, and military parachute trainees share but rarely 'fess up to? Bladder problems. We're talking dribbles, sudden leaks, soaked pads, and mad dashes to the bathroom.

Thanks to the billion-dollar absorbent-products industry—there are now even padded boxer shorts—it's easier than ever to hide urinary incontinence. But should you?

You may have heard that incontinence and overactive bladder issues are on the rise. More than half of women deal with bladder issues, and it's increased 30% in men just since 2002. Aging, hormone changes, pregnancy, childbirth, physical stress (e.g., gymnastics, parachuting) all play roles, but so do new factors, such as the obesity-diabetes epidemic and the increase in radiation and surgery for prostate cancer. About 156,000 men have potentially life-saving prostate cancer surgery each year; 80% leak for at least 6 months and up to 65% still have incontinence issues after 5 years.

More guys than once thought—as many men as women—also have bladder muscle spasms (aka overactive bladders), triggering panicky "gotta go" urges. However, these are often misdiagnosed as enlarged prostate problems. See a urologist to be sure. 

That's a lot of Depends adult diapers and daily difficulties for loads of people (you?). Incontinence dampens your enthusiasm for exercise, sex, going out, even attending meetings (gotta . . . hold . . . it . . . till break time). Yet few women and fewer men ask for help. The price of silence: missing out on improving stay-dry solutions. Here are some tips to try:

Do Kegels. The exercises called Kegels help more than 80% of women with stress incontinence—the leak-when-you-sneeze type—stay way dryer. The surprise? They work for guys, too. Men with overactive bladders—the gotta-go-now-oops-didn't-make-it type—have fewer accidents when they do Kegels daily, as do men who've had prostate surgery.

The trick? Working the right muscles. Many people squeeze their butt, thigh, or tummy muscles by mistake. To find your pelvic-floor muscles, do this: On your next bathroom trip, stop your stream of urine, then throw in the clench you’d use to hold back gas (yep, a fart). Those are the muscles you're after. Squeeze, then completely relax them. Build up to 20 to 30 a day. Since nobody can see this, you can do Kegel exercises anywhere: pumping gas, at your desk, or in a grocery line.

Skip "urge-to-pee" drinks. It's a no-brainer that your bladder's going to yell after chugging a giant bottle of water, but you may be over-stimulating it in other ways. Caffeine, fizzy drinks, artificial sweeteners, alcohol, tomatoes, and citrus can all trigger an overwhelming urge to go. Also, sip slowly throughout the day.

Keep a "pee diary." For 3 days, write down what you do and when your bladder loses control. Then look for connections. You may find patterns you can change easily, such as the afternoon urge that always hits after your supersize diet cola. You may also find connections your doctor can help with (see below), such as a bladder that always acts up when you walk in the front door.

Work with your doc. You owe it to yourself if you're not staying dry.

  • Get a check for health problems or medications, such as some blood pressure drugs, that can cause trouble.
  • Be sure you're doing Kegels correctly. If not, a physical therapist can quickly make a big difference.
  • For overactive bladders, discuss hypnosis, visualization, acupuncture, and bladder retraining techniques. All can put your brain back in control so you can stroll—not sprint—to the toilet.
  • There are also prescription drugs that calm overactive bladders.
  • Surgical techniques can help tightly shut your urethra (the tube that carries urine out of the body) or reposition a bladder that shifted during childbirth.
  • For women, a plastic ring called a pessary can also stabilize a shifty bladder or tighten a leaky urethra.
  • There are other treatments too, including muscle injections and nerve stimulants.

Speak up. Soon you'll be walking right past those pads in the drugstore and taking long road trips worry-free.

Medically reviewed in August 2019.

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