The Leaky Bladder Part 1: The Problem and the Diagnosis

Just the Facts, Just the Stats

Almost everyday I have patients who laugh so hard that tears of joy run down their legs. “Don’t make me laugh” they say! Or they gotto go, gotto go, gotto go! They pull up their driveways and put they in the door and they start leaking. How awful. Yep, incontinence, leaky bladder, poor bladder control, always needing to sit near an exit, at the end of an isle, near the bathrooms. Toilet mapping becomes a sport with every known bathroom targeted and memorized, seared into the brain.

• Do you leak with activities such as coughing, sneezing, jumping, getting in and out of a car?

• Does the sight or sound of water give you urgency to pee?

• Are you having to pee every 30 minutes?

• Do certain foods such as fruit juices, coffee, beer and wine make you want to pee often and right away?

Well, this is what I will cover today: Who gets this and what is is? I give this talk every year via Zoom or live and in person and is my bread and butter problem I take care of in my Urogynecology practice here in Laguna Beach. At the bottom of this newsletter is the link to a full Zoom Video I gave a year ago. That one has me speaking and videotaped so it is pretty cool. Read on!

Red Alinsod, MD

Alot of my career has been focused on the Leaky Bladder. Both surgical and non-surgical management. I have several patents for treatments over the past 30 years so I can tell you that this is a problem that is quite common for those who have had vaginal childbirth or are just getting older.

So let’s go ahead and start. Will cover the top part of this overview today and the Solutions part next week. It is alot of stuff to cover.

So here is a summary of the types of Leaky Bladder or “Incontinence” below. Stress incontinence is the leakage of urine related to activities that increase the abdominal pressure that pushes on the bladder such as laughing, coughing, sneezing, jumping. The “Stress” spoken about is the increased pressure pushing on the bladder and urethra. It is not emotional stress or psychiatric stress.

Urge incontinence is the sudden need to go. With or without triggers. Some people get triggered by the sight and sound of water, alcohol and caffeine, citrus, bananas. Urgency often has frequency tagging along. Having to pee more than 7 times in 24 hours or waking up at night with the urge to pee (called nocturia) were symptoms that helped make the diagnosis.

Then there are those that have all the above symptoms. Leakage with activity AND urgency and frequency. We call that Mixed Incontinence.

Sometimes because of birth trauma and prolonged labors there is a hole between the bladder or urethra and the vagina so that the vagina is constantly wet. That is called a fistula. A true hole urine leaks out of into the vagina.

The bladder leakage is can have very serious personal consequences:

The problem is so large worldwide that it has been know to be the fasts growing growing category in the feminine health market.

The problem is so huge and common that I teach doctors how to diagnose and treat these problems in my offices and at international meetings. The Alinsod Institute has become a training center for the world.

Here are some facts to consider: