‘Pee’ Controlling in Women: Tips to Manage Urinary Leak

Do you know why our elderly parents avoid going out with us? You must have heard them saying that they will get tired, cannot walk, will have body aches, knee pain, won’t enjoy themselves, and many other reasons when asked to go out with us on a trip or shopping. Is that the actual reason or are they withholding something else? Maybe, most of them are having issues with controlling their bladder or bowel calls. More specifically, ‘pee’ control.

Every one of us, I mean we, women, would have experienced this accidental urine leak on forceful coughing or sneezing. There is a list of reasons for urine leaking and can occur at any age based on the type and cause. But it is particularly common in older people, especially in women over the age of 50. It could be due to diseases such as urinary infection or uncontrolled diabetes, due to medications taken for some other illnesses, physical disabilities to rush to the bathroom, constipation, or just aging.  

Leaking urine with or without your knowledge is what we call ‘Urinary Incontinence’ (UI). It is not that it happens only in the elderly or in all who are aging, but as we age, bladder tissue may lose its elasticity, become less flexible to hold as much urine as before, and might make you go to the bathroom more often. In addition, the bladder wall and pelvic floor muscles may weaken, leading to difficulty in emptying the bladder fully and causing urine to leak. Women are more at risk of developing UI due to pregnancy, childbirth, and the hormonal changes of menopause.

Treatment for UI may include lifestyle changes, pelvic floor exercises, medications, nerve stimulation, surgery, or a combination of these treatments. You will find information on these things in several online articles. I only want to focus on sharing tips to help our elders cope with the condition and equip our women to prevent any such conditions later in life.

UI, if managed well, is not a life-threatening problem or a dangerous illness. The truth is, it is the embarrassment that is more worrying than the actual problem. I may give an insight here, but it is important to talk with your doctor or a community health worker right away as and when the need arises.

At home, if your elderly parents or grandparents have this issue,  

• First and foremost, make yourself aware, then speak to them, make them feel comfortable, and assure them that it is all common and okay.
• Have a thorough check-up from a doctor to rule out any causes or risks that may require prompt medical or surgical attention.
• Review their diet. I am sure they will be fond of their coffee or tea, several times a day. Encourage them to avoid or cut down on these caffeinated drinks that irritate the bladder. Let them have a diet rich in fibre and vegetables, to avoid constipation.
• Limiting drinks before bedtime can help in avoiding incontinence at night times, but as a whole don’t limit water intake.
• Keep hallways clear and the bathroom clutter-free, with a light on and the door open at all times. Also, install elderly support rails and handlebars in the bathroom.
• Provide regular bathroom breaks. Help them to schedule a time interval to void urine even when they don’t have the urge to pass urine. Alarms or reminders can be set during the daytime to adopt a routine. For example, they can set a plan to urinate every hour. As time goes on, the time between toilet breaks can be slowly extended.
• Encourage them to use adult diapers at night times and for outings and trips away from home. This would not only save the embarrassment but also prevent urinary infections. However, care needs to be taken as to regular changing and disposal of the diapers. Also, they need to be encouraged to use the toilet whenever possible even if they are wearing diapers.
• Lastly, educate [take help from the expert] them about pelvic floor exercises as they may help in strengthening the pelvic floor muscles that support the bladder and its opening.

We, women, in our forties, can help ourselves now, to not have UI in the future by following a few routines mentioned below. As I said, all elderly will not have this condition. And it is not guaranteed that you will not at all have UI if you follow the below. But there is no harm in trying, right?

• The usual things to take care of are diet, fluid intake, physical activity, and sleep to maintain a healthy weight and lifestyle.
• Prevent constipation: A high-fibre diet and liquids will help you do that.
• Avoid lifting weights, rope skipping, straining while passing stools, or any such activity that will exert pressure on your pelvic floor and aid in the weakening of its muscles.
• Educate yourself and young girls to urinate at regular intervals and not to postpone until real urgency. It would prevent urinary infections and unnecessary pressure on the pelvic floor.
• Do not self-treat urinary infections using antibiotics given by your neighbor, a colleague, or a relative with similar symptoms. Always do urine testing for infection and antibiotic sensitivity before starting the antibiotics prescribed by the doctor. Once the medicine course is finished, please check if the infection has cleared up by testing the urine again. It seems cumbersome but believe me it is the right thing to do.
• Most importantly, Do pelvic floor muscle exercises regularly. These are known as ‘Kegel Exercises' [link]. Daily exercises can strengthen the pelvic floor muscles, which can help keep urine, stools, and gas from leaking suddenly and inappropriately. These exercises also may help avoid infections by strengthening the muscles that help empty the bladder.
• Lastly, always remember to reach out to your doctor, a family physician, or a gynecologist if you develop even the slightest symptom of any of the urinary problems. Remember, prevention could be better, but early diagnosis and treatment is the key.