Urine stays inside your body when the pelvic floor and sphincter muscles
are tight and the bladder is relaxed.
Parts of the
bladder control system: nerves and brain
When the bladder is full, nerves in
your bladder signal the brain. That's when you get the urge
to go to the bathroom. Once you reach the toilet, your brain sends a
message down to the sphincter and pelvic floor muscles. It tells them to
The brain signal also tells the bladder
muscles to tighten up. That squeezes urine out of the bladder.
Bladder control means you urinate only when
you want to. For good bladder control, all parts of your system must work
muscles must hold up the bladder and urethra.
muscles must open and shut the urethra.
must control the muscles of the bladder and pelvic floor.
What causes bladder control problems?
Most bladder control problems
happen when muscles are weak or too active. Problems may also happen when
nerve signals don't work properly.
If the muscles that keep your
bladder closed are weak, you may have accidents when you sneeze, laugh, or
lift a heavy object. This is called stress incontinence. It is the
most common type of bladder control problem.
Stress incontinence often
occurs when women are pregnant or after childbirth. The pelvic floor
muscles stretch and weaken in pregnancy or childbirth.
The same muscles become weak
after a woman stops having periods (menopause). They weaken because they
no longer get female hormones.
Sometimes, the bladder muscles
become too active. Then you have a different problem. You may feel
strong, sudden urges to go to the bathroom, even if your bladder has
little urine. This kind of bladder problem is called urge incontinence
or overactive bladder.
Several things can cause your bladder to be
damage (sometimes from childbirth)
alcohol (beer, wine, etc.)
What is the treatment for bladder control problems?
Your treatment will depend on the type of
bladder control problem you have. Some treatments are simple. Others are
more complicated. Your health care team may suggest one of the following
Pelvic muscle exercises. You can
learn simple exercises that can strengthen the muscles near the urethra.
These are called pelvic muscle exercises or
Kegel exercises and take only a few minutes a day.
Weak bladder control muscles
Strong blader control muscles
Bladder training. You can train
your bladder to hold urine better. Follow a timetable to store and
release urine. You can also learn to decrease the urge to urinate.
Weight loss. Sometimes extra
weight causes bladder control problems. A good meal plan and exercise
program can lead to weight loss.
Food and drink. Some drinks and
foods may make urine control harder. These include foods with caffeine
(coffee, tea, cola, or chocolate) and alcohol. Your health care team can
suggest how to change your diet for better bladder control.
Electrical stimulation. Certain
devices stimulate the muscles around the urethra. This makes the muscles
stronger and tighter.
Biofeedback. This takes the
guesswork out of pelvic muscle exercise. A therapist places a patch over
the muscles. A wire connects the patch to a TV screen. You watch the
screen to see if you are exercising the right muscles. The therapist
will help you. Soon you learn to control these muscles without the patch
Medicines. Certain drugs can
tighten or strengthen urethral and pelvic floor muscles. Other medicines
can calm overactive bladder muscles and nerves. A skin patch can be worn
to treat symptoms of overactive bladder.
Surgery. Some bladder control
problems can be solved by surgery.
Many different operations can improve
bladder control. The operation depends on what is causing the problem.
In most cases, the surgeon changes the position of the bladder and
urethra. After the operation, the bladder control muscles work better.
Pessary. Your doctor can place a
special device called a pessary (PESS-uh-ree) in the vagina. The device
will hold up the bladder to prevent leakage.
Urethral inserts. Your doctor may
give you a small device that goes directly in the urethra. You can learn
to insert the device yourself. It's like a little plug. You remove the
device when it is time to go to the bathroom and then replace it until
it's time to go again.
Urine seals. This is a small foam
pad you place over the urethra opening. There it seals itself against
your body to keep urine from leaking. When you go to the bathroom, you
remove the pad and throw it away.
Soon you will be able to buy new products
to help control leaks. However, they do not cure the causes of bladder
Pads or diapers. Pads or diapers
help many people. But diapers do not cure bladder control problems. See
a doctor or nurse, even if diapers are working for you.
Bedside urinal. Some people use a
bed pan or a bedside chair urinal (YOOR-uh-nul) or commode.
Assistance. If you are disabled,
health care workers can help you move more easily to a toilet. Your
doctor or nurse may teach you to urinate on a schedule that prevents
Renovations. Sometimes, you just
need a carpenter to make changes to your house. Perhaps you need a
hallway light. Or a downstairs bathroom. Another solution could be
widening a bathroom door to fit a wheelchair.
women have bladder control problems.
control problems do not have to be a normal part of aging. Many
medical conditions can cause bladder problems.
not to let embarrassment about bladder control problems keep you from
talking to your health care team.
cases of poor bladder control can be improved greatly. Ask your health
care team for help.
Pelvic Floor Muscles:
Pelvic Fitness in Minutes a Day
Exercising your pelvic floor muscles for
just 5 minutes a day can make a big difference to your bladder control.
Exercise strengthens muscles that hold the bladder and many other organs
The part of your body including your hip
bones is the pelvic area. At the bottom of the pelvis, several
layers of muscle stretch between your legs. The muscles attach to the
front, back, and sides of the pelvis bone.
pelvic muscles do most of the work. The biggest one stretches like a
hammock. The other is shaped like a triangle. These muscles prevent
leaking of urine and stool.
Find the right muscles. This is very
important. Your doctor, nurse, or physical therapist will help make sure
you are doing the exercises the right way.
You should tighten the two major muscles
that stretch across your pelvic floor. They are the "hammock"
muscle and the "triangle" muscle. Here are three methods to
check for the correct muscles.
- Try to stop the flow of urine when you
are sitting on the toilet. If you can do it, you are using the right
- Imagine that you are trying to stop
passing gas. Squeeze the muscles you would use. If you sense a
"pulling" feeling, those are the right muscles for pelvic
- Lie down and put your finger inside your
vagina. Squeeze as if you were trying to stop urine from coming out.
If you feel tightness on your finger, you are squeezing the right
Don't squeeze other muscles at the same
time. Be careful not to tighten your stomach, legs, or other muscles.
Squeezing the wrong muscles can put more pressure on your bladder control
muscles. Just squeeze the pelvic muscle. Don't hold your breath.
Hold the Squeeze 'til After the Sneeze
You can protect your pelvic muscles from
more damage by bracing yourself. Think ahead, just before sneezing,
lifting, or jumping. Sudden pressure from such actions can hurt those
pelvic muscles. Squeeze your pelvic muscles tightly and hold on until after
you sneeze, lift, or jump.
After you train yourself to tighten the
pelvic muscles for these moments, you will have fewer accidents.
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Do pregnancy and childbirth affect bladder
Yes. But don't panic. If you lose bladder
control after childbirth, the problem often goes away by itself. Your
muscles may just need time to recover.
When do you need medical help?
If you still have a problem after 6 weeks,
talk to your doctor. Without treatment, lost bladder control can become a
long-term problem. Accidental leaking can also signal that something else
is wrong in your body.
Bladder control problems do not always show
up right after childbirth. Some women do not begin to have problems until
later, often in their 40's.
You and your health care team must first
find out why you have lost bladder control. Then you can discuss
After treatment, most women regain or
improve their bladder control. Regaining control helps you enjoy a
healthier and happier life.
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Can you prevent bladder problems?
Yes. Women who exercise certain pelvic
muscles have fewer bladder problems later on. These muscles are called
pelvic floor muscles. If you plan to have a baby, talk to your
doctor. Ask if you should do pelvic floor exercises. Exercises after
childbirth also help prevent bladder problems in middle age.
How does bladder control work?
Your bladder is a muscle shaped like a
balloon. While the bladder stores urine, the bladder muscle relaxes. When
you go to the bathroom, the bladder muscle tightens to squeeze urine out
of the bladder.
More muscles help with bladder control. Two
sphincter (SFINK-tur) muscles surround the tube that carries urine from
your bladder down to an opening in front of the vagina. The tube is called
the urethra (yoo-REE-thrah). Urine leaves your body through this tube. The
sphincters keep the urethra closed by squeezing like rubber bands.
Pelvic floor muscles under the bladder also
help keep the urethra closed.
When the bladder is full, nerves in your
bladder signal the brain. That's when you get the urge to go to the
bathroom. Once you reach the toilet, your brain sends a message down to
the sphincter and pelvic floor muscles. The brain tells them to relax. The
brain signal also tells the bladder muscles to tighten up. That squeezes
urine out of the bladder.
Strong sphincter (bladder control) muscles
prevent urine leakage in pregnancy and after childbirth. You can exercise
these muscles to make them strong. Talk to your doctor about learning how
to do pelvic floor exercises.
What do pregnancy and childbirth have to
do with bladder control?
babies push down on the bladder, urethra, and pelvic muscles.
The added weight and pressure of pregnancy
can weaken pelvic floor muscles. Other aspects of pregnancy and childbirth
can also cause problems:
- changed position of bladder and urethra
- vaginal delivery
- episiotomy (the cut in the muscle that
makes it easier for the baby to come out)
- damage to bladder control nerves
Which professionals can help you with bladder control?
Professionals who can help you with bladder
primary care doctor
gynecologist (guy-nuh-CALL-uh-jist): a women's doctor
urogynecologist (YOOR-oh-guy-nuh-CALL-uh-jist): an expert in women's
urologist (yoor-ALL-uh-jist): an expert in bladder problems
specialist in female urology
nurse or nurse practitioner
Points to Remember
bladder control problems are common during and after pregnancy.
pelvic floor muscles can help prevent bladder control problems.
control problems may show up months to years after childbirth. Talk to
your health care team if this happens to you
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