Please help, I'm 21 and I have incontinence problems.

June 28, 2011 2:59 AM

Please help, I'm 21 and I have incontinence problems.

I'm 21 years old and I have incontinence problems (I don't have them because of any medical issues/conditions), but I am very bad at holding on to go to the toilet.

From when I was a young boy I have always struggled with holding on. When I was about 12-16 years old I would regularly go every hour and only be drinking about 2 pints of water a day.

Now that I'm 21, I drink about 3 pints of water a day and still need to go every 1-2 hours. I've asked my doctor about it before and had relevant blood tests and such but they have all been clear. I also find that on long bus or car journeys (where I won't be able to go for a long period of time) that I can hold on for even less time. It does vary however, as sometimes I can hold on for three hours, and other times I'll only be able to hold on for 45 minutes.

Due to being in situations where I must go and then hold on for a long period of time I have tried to push out the last few drops of urine whilst going and badly pulled a muscle around my bladder by doing so. I have almost sorted that now. I'm pretty sure it is a psychological problem, but I have no idea how to make it better.

I'm at ease with needing the toilet so much and I'm not bothered by other people trying to make fun of me for it, but as I'm heading into the world of full time work soon I feel that I need to do something properly to make it so I don't need the toilet every hour. I have tried to train myself, but there is very little improvement after doing this for months.

Can someone please recommend something that I can try/do to sort this problem out as it is an unnecessary burden on my mind and is stressing me out as I thought it would of disappared as I became and adult.

(Note, I live in the UK)

posted by sockpim to health & fitness (12 answers total)

This sounds distressing; I'm sorry you're having these issues.

I think you are going to have to go back to your GP and ask for a referral to a urologist. There are also drugs you can take these days for incontinence and weak bladder; you might ask if you can start one on a trial basis whilst waiting for an appointment.
posted by DarlingBri at 3:10 AM on June 28, 2011

If you are cleared by a urologist and the issue is still not resolved, ask for a referral to a physical therapist who specializes in the pelvic floor. This is an issue that they treat often. They are sometimes called Women's Health physical therapists, but this is a misnomer, because this is a problem for men as well.
posted by jennyjenny at 3:15 AM on June 28, 2011 [1 favorite]

I second DarlingBri's suggestion on going to your GP. There are some simple and cheap medications that you can use that should relieve the problem if it is simple 'urge incontinence' or 'overactive bladder' - could really help you out during your workday. I'm in the USA, but we use oxybutynin.
posted by treehorn+bunny at 3:32 AM on June 28, 2011 [1 favorite]

Here's something which may be useful. Also, instead of trying to "push" it out, you may get better results by focusing on relaxing every muscle.
posted by alexei at 3:49 AM on June 28, 2011

This could be a job for kegels!
posted by SueDenim at 4:38 AM on June 28, 2011 [3 favorites]

I believe there are at least a dozen conditions that can cause frequent urination, but I take it you've been checked out, and I agree that it sounds psychological. I do know it can be a symptom of anxiety problems to name but one (bit of a vicious circle there).

But I think the dull answer, as others have said, is that you have to go back to the GP and keep pressing till something effective is done. It's understandably easy for a busy doctor to assume that if someone doesn't come back they must be OK now, but it's not acceptable for them to say "well, you're just a pisser, no more we can do". I wouldn't suggest or ask for anything in particular - make them do the diagnosis.
posted by Segundus at 4:50 AM on June 28, 2011

No specific suggestions, but I just want to say that it's perfectly OK to go to your GP again - and if you can, try to emphasise that this is really a problem and that you're not happy with the current situation. Blood tests may have been "clear" before, but you do still have a problem and your GP needs to address this with you. But you might need to be a bit assertive in order to start the process.

Good luck!
posted by altolinguistic at 4:59 AM on June 28, 2011 [1 favorite]

I work specifically in continence. Exactly as darlingbri says, you need to back to your GP, who should check your urine, and ask you to fill out a bladder diary. They might start treatment, or they might refer you to a specialist urologist for further tests. Offering no treatment or investigation should not be an option.

To prepare for your GP appointment, have a look at the resources on the Bladder & Bowel Foundation website, and specifically their advice about urgency and urge incontinence.

If you PM me, I can try to recommend you a specialist in your area that you could ask to be referred to.
posted by roofus at 5:55 AM on June 28, 2011 [3 favorites]

IANAD, and I have no idea what I'm talking about. But I've had to deal with a lesser version of this. I'm thinking kidneys or nervous system or both, sub-clinically. Your kidneys tell your body to hold onto water. Your nervous system dynamically sets the threshold for how much urine collects before you have to pee, and your nervous system controls vascular dilation (and your kidneys) which influences blood volume and urine processing.

Three things specifically have improved this issue for me:

1. Buteyko breathing. http://www.buteykocenterusa.com/buteyko_estore.html (Specifically check out the ebook.) This will stimulate your kidneys and increase your autonomic tone. You have to give it several months. Are you a mouth breather, or do you have allergies, or are you a terrible athlete, by any chance? Even if not, it's worth a shot--it only takes a few minutes a day.

2. Eating a shitload more. Gain lean weight. Gain any kind of weight. If your muscles are getting bigger (and you're not overdoing it and taking plenty of time to recover), your body is getting repaired in other ways too. This was key; don't brush it aside. If you're overweight, do you have muscle, too? If not, you have to eat for muscle (repair).

3. Work up to daily walks that last at least one hour. (If that seems insane, you are definitely not eating enough. Slowly increase your food intake--months--until you're desperate for physical activity.) All sorts of positive changes happen to your vascular and nervous system when you do long, low key, upright exercise. I suspect walking is much better than running or biking.

These three things work together. I can drink much more without having to pee instantly, and I typically sleep through the night now without getting up to pee. I would try making a laid back effort on all three of these things, working up to everything over months, and see what happens. It may take 6-12 months before you see big changes--but you're physically reconfiguring your body, so you have to be patient.

YMMV.
posted by zeek321 at 6:42 AM on June 28, 2011

I had a hassle along these lines a bit after having a baby, and then dealt with a tremendous amount of investigation/therapies/etcetera that were at best utterly useless.

Finally I was told "Don't go so often." What? Why, you insensitive, ignorant... "Really, just stop peeing all the time." But do you not understand why I am here in your office? Ridiculous!

However, it worked. Gradually. I know you have said you've tried, but, FWIW, this was totally worth it for me and I no longer have a problem.

One thing that turned out to be key was that whenever I saw a toilet or knew I was near one, my bladder said "C'mon! You know you wanna!" Easy to recognise that as BS, though, as my bladder had not been thinking about it until the toilet came into proximity. So that was the first line of "No, I'm not buying that. You will wait," and that was (relatively) easy and effective. Definitely don't try to squeeze out last drops or otherwise pee unnaturally when you do go.

My lay advice is to persist with the 'training,' but I do Nth seeing a specialist. There are physiotherapists who deal exclusively with this sort of thing. Do beware of batteries of uncomfortable testing that may not be indicated for your precise situation; ask a great deal of questions -- what will the next step be if the results are X, what will the next step be if the results are Y, why will this test be useful in determining treatment in a way simply asking me questions will not be, and so on.
posted by kmennie at 8:37 AM on June 28, 2011 [2 favorites]

A urologist I know recommends avoiding dyes, as in Koolaid and Jello; they may irritate the bladder, causing frequency. Most foods with lots of additives are not great for you, so this can't hurt.
posted by theora55 at 9:51 AM on June 28, 2011 [1 favorite]

Try kegels? Maybe your bladder muscles just suck
posted by phrakture at 3:18 PM on June 28, 2011