Help me stop leaking when I stand up!

November 29, 2006 3:06 PM

Morning / night time urinary incontinence filter. Why do I leak when I stand up??

Ok. This is going to be a long one, as it's anonymous. Sometimes, when I wake up in the night or in the morning and need to pee, I leak. A lot. I can feel that it's going to happen when I'm in bed, but it only leaks when I stand up. When I do stand up, it just all falls out. This isn't just a little bit - it's a lot - nearly all of it. I rush to the toilet, but the movement makes it leak more. I'm pulling my muscles in, but still leaking. WhenI get to the toilet, I can still do that 'push' thing, and more comes out.

It doesn't happen all the time though. I've got 'getting out of bed' into an art form now - so it doesn't wet my mattress. It happens when I have had alcohol, and when I haven't. I've cut out caffeine completely from my diet, don't drink tea - decaff - (or maybe only drink one) in the 2hours before I go to bed. I always wear cotton knickers, go to the toilet before I go to bed, have changed washing powder, am not stressed about anything in my life.

It's not stress incontinence - I don't leak during the day when I cough or sneeze. And it doesn't affect me during the day - so it's unlikely to be urge incontinence.

I went to a Doctor about a year and a half ago. He checked for UTIs - none. Sent me to a nurse to check my bladder and other muscles round there - and they're fine. But I need to get this sorted out. I need something to go to the Doctor with to get them to do something. I can't go anywhere. I daren't stay in a hotel or at a friend's house. I can't stay anywhere where the toilet is on a different floor to the bedroom.

Does anyone have any idea what this is?? It only happens when I wake up - sometimes - not all the time - needing the toilet. Then when I stand up, it's like a waterfall. I'm desperate for some help. Anyone??

Information: I'm 28, female, overweight. I take the pill for Polycystic Ovarian Syndrome and have an underactive thyroid (which I take Thyroxine for). I also take Effexor XL (112.5mg per day). I smoke, don't drink caffeine at all and don't exercise regularly. This has been going on for about 4 years on and off now. Sometimes months between episodes, sometimes just days. Can't pin it down to any factor causing it. And I'm in the UK if that's relevant.

posted by anonymous to health & fitness (10 comments total)

I'm sorry you are dealing with this. It sounds very frustrating, and asking another doctor might help. But whatever the cause and cure, you mustn't feel like you can't travel. You can buy adult-sized diapers (online if you are embarrassed) and wear them just in case. If you wear a loose nightgown no one will be able to tell you are wearing them, unless you want them to know. I hope you get an answer, good luck.
posted by Scram at 3:38 PM on November 29, 2006

If you're worried that caffeine is a factor then 2 hours before bed isn't enough. It can take 3 to 7 hours to metabolize. You're also not doing yourself any favors with the smoking; I vaguely recalled reading about an effect of tobacco on muscle fibers and a cursory googling confirms it. I don't know that either of those things are going to help you but if you're prepared to alter things in your life to try to deal with this then those are two good ones.

Have you tried making PC muscle exercises a part of your daily routine? There's no harm in it and it's easier than quitting smoking, to boot.

I'd certainly say you should consult a urologist if you can get an appointment; they're going to be more conversant with these kinds of matters than a GP.
posted by phearlez at 4:08 PM on November 29, 2006

Get yourself a chamber pot until you get this sorted out.
posted by flabdablet at 4:52 PM on November 29, 2006

Could this be of any help to you, I wonder?
posted by WCityMike at 5:29 PM on November 29, 2006

I am going to give you a gift............are you ready?
Here it comes...............
Cut out all artificial colours and preservatives from your diet. You will be amazed at the result. I don't have to wish you good luck, as I know this will work. :)
posted by pennee at 6:14 PM on November 29, 2006

Have you had a baby? In any event, this is not that uncommon for females. There are simple surgical procedures which can help. Search for "bladder neck suspension."
posted by caddis at 6:27 PM on November 29, 2006

See a urologist and get urodynamics. Also, determining whether this incontinence results from sleeping or rather just from lying down would be useful.
posted by wireless at 1:15 PM on November 30, 2006

These things can be tricky to diagnose. I notice that the original poster is already certain that it's not stress or urge incontinence, and some respondents are already advocating surgery or certain tests.

This is all wrong. You don't know why this is happening. The first step is to have it diagnosed by someone who understands how diagnosis is done, what could be wrong, and what tests to perform to find out whether those things are in fact wrong. The average GP isn't capable of it - you need a urologist.

I suspect the reason you haven't yet been referred is that your GP doesn't appreciate the magnitude of the problem. Put a bucket by your bed and next time it happens, capture all the urine in the bucket. Then bottle it so you can show your GP just how much urine you're losing. A lot of women might lose a few drops, but not a "waterfall" - if you can quantify a pint or a quart or so on, you'll be better able to argue for a referral.
posted by ikkyu2 at 12:21 AM on December 1, 2006

Apparently incontinence of the type you describe may be a symptom of a pinched nerve. Have you had a back injury, ever?

Recently I went to my dr for leg pain and a limp that hadn't gone away for about a year. We had tried physical therapy and hadn't gotten anywhere and an MRI had been mentioned as the next step. This time she asked about problems with incontinence. As it happens, I've had problems for a couple months where the urge to pee hits me shortly after I stand up and it hits HARD, to the point where I rush to the bathroom trying not to squirt. The MRI showed a couple pinched nerves, and combined with the peeing issue, makes this a somewhat significant problem. I have an appointment with a neurosurgeon to relieve a pinched nerve in my spine. A laminectomy is one proposed solution.

Problems with incontinence can be really debilitating and a major cause of depression. This is not an acceptible condition to live with the rest of your life. A year and a half with this problem is too long.
posted by faceonmars at 9:46 AM on December 1, 2006

Second try doing pelvic floor exercises. You can do them nearly anywhere, at any time.
posted by ostranenie at 8:41 PM on December 2, 2006