Ahuriri Pharmacy advice: How to manage bladder control and continence issues

Pharmacist Mel Barber (right) from Ahuriri Pharmacy assists a customer.

OPINION

Lack of bladder control and incontinence affects one in three women and one in 10 men. Many consider it a normal part of ageing, but it is often not discussed or treated.

Incontinence broadly falls into three categories – stress, urge and mixed.

Stress incontinence can result from stretching pelvic floor muscles in pregnancy, chronic constipation or obesity and occurs with coughing, sneezing, straining or playing sport.

Urge incontinence is when the bladder becomes overactive, contracting when it isn’t full or the muscles work overtime, causing frequent, sudden urges and bladder leakage.

Continence can also be affected by some medications, urinary infections, diseases, menopause and prostate gland enlargement.

Lifestyle changes

Lifestyle changes can improve control in around 50 per cent of cases.

Try:

• Altering fluid intake to 1.5L/day and minimising evening intake;
• Limiting caffeine and alcohol;
• Avoiding or treating constipation by increasing fibre intake in wholemeal bread, cereals, fruit and vegetables;
• Practicing regular toileting habits with good posture for complete emptying.

Combining calcium and magnesium may help prevent bladder spasms, while zinc-rich foods like fish and dark green vegetables may help improve function.

Schedule toilet visits to help increase the time between passing urine so the bladder muscle strengthens and can hold more without emptying.

Regularly do pelvic floor exercises by tightening pelvic floor muscles for 3-5 seconds, increasing to 10 seconds as the muscle strengthens. Relax for as long as the muscles are tightened. Do this 5-7 times, 3 times a day, to increase to 15 exercises, 3 times a day.

If these measures aren’t successful, pads can be useful to give confidence in day-to-day life. The most used medicines are anticholinergic and alpha-adrenergic agents.

The older anticholinergics (oxybutynin, antidepressants) reduce the number and strength of bladder contractions. They are subsidised, but side effects are frequent.

Newer medicines aren’t subsidised but may be easier to tolerate. Alpha-adrenergic agents contract the muscles around the bladder neck to form a tighter seal and prevent leaking. Discuss these and other measures with your doctor.

The information provided is a guide and not intended as a comprehensive medical service.

It should not be used as a substitute for seeking professional medical advice.