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The Wet Woman

Posted on October 12, 2017 | No Comments on The Wet Woman

Accidental or involuntary leakage of urine, or urinary incontinence, is a common problem afflicting many women, both young and old. Unfortunately, many suffer in silence. This is so because they either feel embarrassed to talk About it or are led to believe that it is a “normal” consequence of childbirth, aging, or menopause or, even worse still, feel that it is a problem without a solution. Nothing could be more false! Poor bladder control is a problem of perhaps half of the female population. Many would try to hide their condition with sanitary pads or adult diapers just to avoid wetting themselves in public. And, there are also some who would rather remain homebound just to get out of a distressing situation. Women who are in their menopause or who are afflicted with certain medical conditions such as diabetes or asthma are of particular risk for urinary incontinence.

Menopause reflects the decline in the female hormones, particularly estrogen, which in turn brings about several changes in the woman’s body including the vagina and bladder.The vagina loses its suppleness and gradually becomes stiff and dry. The bladder, which sits on top of the vagina, inevitably becomes affected by such changes. And, since majority of bladder problems occur in the older age group, co-existing medical conditions often aggravate urinary symptoms. For instance, diuretics are frequently given for hypertension and heart disease.

Bladder problems in women can come in many forms but can generally be categorized into two – problems with storage and problems with emptying. When there is difficulty holding urine, the most common conditions would include Overactive Bladder and Stress Urinary Incontinence. In diabetics, the opposite is often true. Depending on the severity and duration of the diabetes, there is often difficulty in passing urine. This becomes a distressing problem since women who do not completely empty their bladders can develop Recurrent Urinary Tract Infections (Recurrent UTI) and Urinary Incontinence (Overflow Incontinence). This is of particular concern since recurrent UTI and voiding difficulties place the kidneys at risk for infections and subsequent damage.

The Overactive Bladder (OAB) is characterized by frequency (urinating > 7 times a day), nocturia (waking up to pass urine > 1 x a night), and urgency (a strong and sudden desire to urinate). Leakage of urine usually occurs when the woman is unable to make it to the toilet on time.These symptoms are the result of uncontrollable and involuntary bladder spasms. Because of this, women suffering from OAB often develop certain habits in order to adjust to their bladders’ attention-seeking behavior. They would often urinate before leaving the house and, upon arriving at their destination, either urinate immediately or search for the nearest comfort room. Since most women often have sleepless nights spending more time in the toilet than in bed, some would even place a commode at their bedside just to avoid a seemingly long trek to the bathroom or, even worse, wetting themselves in bed. Inevitably, these women become overly conscious of their smell, of their clothing, and of their hygiene. Some develop a form of depression and social withdrawal. Thus, in a select group of women,it is a serious problem.

At the other end of the spectrum, some women, particularly those in the older age group, experience problems when passing u’rine, such that they either have difficulty urinating or do not completely empty their bladders whenever they go. This is referred to as Voiding Dysfunction or Urinary Retention, respectively. Diabetics are common victims since diabetes can affect the urinary bladder in such a way that the bladder becomes insensitive/numb, weak and lazy. A condition referred to as DM Cystopathy. As a result, the woman would have to strain to urinate or to completely empty. Unfortunately, in majority of cases, they fail. In these cases, the phrase “the glass is always half full” could not be more appropriate. The retained urine then becomes a source of infection and, if undetected, a cause for Recurrent UTI. In some instances, the amount of urine retained in the bladder gradually accumulates and distends the bladder to a point that the urine “overflows” and leaks out (Overflow Incontinence).

Voiding disorders deserve special attention because these have the potential to create serious problems. If undetected or ignored, patients may develop severe infections, worsening kidney function, or even kidney failure. Urinary tract infections must therefore be immediately treated with antibiotic’ therapy. Although most urinary infections are not dangerous, an earnest search for the cause must be instituted especially if they occur at least three times in a year. A normal individual would, on the average, have three to, four hours between voids depending an the amount of fluids taken. Going too much or too little is, therefore, a cause for concern. Just to check if you have a problem, you can try answering the following questions:

  1. Do you leak urine when you cough, sneeze, or laugh?
  2. Do you ever have an uncomfortable strong need to urinate that if you don’t reach the toilet you will leak?
  3. Do you ever leak before you reach the toilet?
  4. How many times during the day do you urinate?
  5. How many times do you void during the night after going to bed?
  6. Have you ever wet the bed?
  7. Do you leak during or after sexual intercourse?
  8. How often do you leak?
  9. Do you find it necessary to wear a pad because of your leaking?
  10. Have you had bladder, kidney, or urine infections?
  11. Are you troubled by pain or discomfort when you urinate?
  12. Have you had blood in your urine?
  13. Do you find it hard to begin urinating?
  14. Do you have a slow urinary stream or have to strain to pass urine?
  15. After urinating, do you have dribbling or a feeling that your bladder is still full?

If you have answered “yes” to any of the above questions, then consultation with your gynecologist is recommended. An abdominal, pelvic, and vaginal exam should be done in order to identify any other cause for the bladder problems. Prior to instituting any form of treatment, certain diagnostic tests are indicated since therapy for one bladder condition may aggravate another. A routine urinalysis and urine culture together with simple imaging studies (like a KUB ultrasound) would be very helpful as these would provide a lot of information on the status of the kidneys and urinary bladder.

However, more specialized tests, called urodynamic studies, may be indicated in certain cases especially in those with more complicated symptoms.There is no cause for alarm or fear though as majority of bladder problems in women can be treated or cured through medication. Whilst it is true that as we grow older in years some things just have to give, we must also realize that there are just certain things that should not be considered a “natural” part of the aging process. Bladder problems, specifically urinary incontinence, are not normal. Once we accept this fact, only then can we be brave enough to ask for help. And, it is then when we will truly understand what it means to “age gracefully”.

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