OUR resident specialist and NHS GP, Dr Zoe Williams, shares her expert advice.
Today, Dr Zoe helps a reader who gets up to pee almost every hour every night.
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Q) I’ve had a lot of trouble down below, with a prolapse, overactive bladder and bleeding.
I go for a wee hourly at night.
Can you advise?
A) Many people suffer in silence with these types of urogynaecological issues, so thank you for writing in to me.
It’s very important that women feel they can be open and speak up about issues like this, so often seen as taboo and brushed under the carpet.
It really frustrates me when I hear terms such as, “It’s part of being a woman” or even, “Women’s problems . . . ”, because it’s not normal and there are treatments.
There are lifestyle measures that can be advised, such as pelvic-floor training and avoiding things that irritate your bladder – think caffeine, alcohol and fizzy drinks, for example.
In addition, there are several medications that can treat an overactive bladder – and alternative treatments, such as pessaries to help support the pelvic organs.
In some cases, surgery is deemed the best treatment strategy but of course this is only if it fits with the patient’s own wishes.
Sometimes it is a case of trying several things to see what works.
The main message is, please do not suffer in silence or believe this is a normal part of being a woman. Please seek support, advice and treatment from your GP so that you can live with the best quality of life.
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What is urinary incontinence?
There are several types of urinary incontinence:
Stress incontinence: when urine leaks out at times when your bladder is under pressure; for example, when you cough or laugh. Causes include weakening or damage to the muscles used to prevent urination, such as pelvic floor muscles and the urethral sphincter.
Urge (urgency) incontinence: when urine leaks as you feel a sudden, intense urge to pee, or soon afterwards. This is usually the result of overactivity of the detrusor muscles, which control the bladder.
Overflow incontinence (chronic urinary retention) – when you’re unable to fully empty your bladder, which causes frequent leaking. This could be caused by a blockage in your bladder, preventing it from emptying fully.
Total incontinence – when your bladder cannot store any urine at all, which causes you to pass urine constantly or have frequent leaking. This could be caused by a problem with the bladder from birth, a spinal injury or a small hole that can form between the bladder and nearby area (fistula).
Pregnancy, childbirth, obesity, increasing age (although incontinence is not an inevitable part of aging) and a family history of incontinence.
