Are you afraid of a sudden cough or sneeze? Do you suddenly have the urge to urinate and can’t make it to the restroom? Is the fear of having an accident keeping you from being physically active, enjoying your hobbies, and even leaving your home?
Know that you are not alone. Urinary incontinence is a common condition known to affect both men and women. And for people with cancer, research has found that more than 70% of those who received chemotherapy complained of lower urinary tract symptoms. Studies have also found that over 30% of cancer survivors continued to experience urinary incontinence but only 20% actually sought treatment.
What is bladder incontinence?
Bladder incontinence is when there is an accidental loss, leaking, or dribbling of urine. Individuals may describe this as having damp underwear or feeling the need to change clothes due to a larger release of urine. Some may describe this as having an increase in frequency, pain and/or discomfort when urinating, or may also have a sense of urgency or being unable to hold their urine until they can get to a restroom.
Certain types of cancers or treatments might have an increased risk for bladder incontinence. Some of the factors than can increase this risk include:
- Tumor pressure in the spine or near the bladder
- Weakening of the muscles that control the bladder and bowels
- Radiation to the pelvis, abdominal, or genital area
- Certain types of chemotherapy or targeted therapy
- Added pressure on the bladder from constipation or impacted stool
- Nervous system disorders
- Urinary tract infection
- Gastrointestinal tract obstruction
- Muscle weakness or lack of activity
- Bladder irritants like caffeine, alcohol, or tobacco
- Urine retention
What are the types of urinary incontinence?
There are several types of urinary incontinence. The most common ones include:
Stress incontinence: The loss of urine is caused by an impaired sphincter function, as a result of weak pelvic floor muscles and nerve malfunction, when there is an increased pressure in the abdomen. Actions such as coughing, sneezing, laughing, exercising and lifting heavy objects can result in an involuntary and uncontrolled discharge of urine.
Urge incontinence (Overactive bladder): Involuntary release of urine due to the sudden urge to urinate and seek a restroom, despite the bladder not being full or trying to delay the symptoms. This is a result of abnormal or overactive bladder contractions due to bladder irritation, spinal cord damage or nerve damage.
Overflow incontinence: The involuntary release of urine due to weak bladder muscles or to a blockage when you are unable to completely empty your bladder. The individual does not usually feel the urge to urinate and results in leakage.
Kegel exercises to improve urinary incontinence:
Kegel exercises which are also known as pelvic floor muscle training exercises, are designed to strengthen the muscles of the pelvic floor. The muscles of the pelvic floor help to support the uterus, bladder, and bowels in women and supports the bladder and bowels in men. Studies have found these pelvic muscle strengthening exercises to be an effective treatment for urinary incontinence for men who performed them prior to prostatectomy and continued after surgery. The exercises were done at least 3 times per day, with on average 10-15 contractions lasting 5 seconds with 10 seconds of muscular relaxation. The literature also suggests that Kegel exercises significantly improves bladder incontinence, if done correctly, and has been shown to increase quality of life and improve physical, mental, and social functioning.
How to do Kegel exercises (3-4 times a day):
- Step 1: Make sure to empty your bladder!
- Step 2: Exercises can be performed sitting, standing or lying down. Try to perform these exercises in all three positions to help increase the strength of the pelvic muscles.
- Step 3: Tighten your pelvic floor muscles, like you’re trying to avoid passing gas, hold for 5 seconds. You can also alternate and squeeze the muscles in your anus (like you’re holding in a bowel movement) and hold for 5 seconds.
- Step 4: Relax the muscles and count to 10.
- Step 5: Repeat 10 to 20 times
Notes: Don’t forget to breathe during these exercises. Do not hold your breath. Try not to tighten the muscles in your stomach, thighs, buttock, or chest.
**Individuals should be aware that results may vary. Consistency and dedication in performing Kegel exercises will help to improve your symptoms of bladder incontinence.**
Author: Simone Singh, CCNM Integrative Cancer Centre intern
References:
- Karlsson L, Bock D, Asplund D, Ohlsson B, Rosenberg J, Angenete E. Urinary dysfunction in patients with rectal cancer: a prospective cohort study. Colorectal Dis. 2020;22(1):18-28. doi:10.1111/codi.14784
- Cho OH, Yoo YS, Kim JC, Park RH, Hwang KH. Factors Influencing Lower Urinary Tract Symptoms in Advanced Cancer Patients With Chemotherapy-Induced Peripheral Neuropathy. Int Neurourol J. 2018;22(3):192-199. doi:10.5213/inj.1836084.042
- American Cancer Society. (2020, February 1). Bladder and Bowel Incontinence. Retrieved November 11, 2020, from https://www.cancer.org/treatment/treatments-and-side-effects/physical-side-effects/stool-or-urine-changes/bladder-incontinence.html.
- Strączyńska A, Weber-Rajek M, Strojek K, Piekorz Z, Styczyńska H, Goch A, Radzimińska A. The Impact Of Pelvic Floor Muscle Training On Urinary Incontinence In Men After Radical Prostatectomy (RP) – A Systematic Review. Clin Interv Aging. 2019;14:1997-2005
https://doi.org/10.2147/CIA.S228222. - Kargar Jahromi M, Talebizadeh M, Mirzaei M. The effect of pelvic muscle exercises on urinary incontinency and self-esteem of elderly females with stress urinary incontinency, 2013. Glob J Health Sci. 2014;7(2):71-79. Published 2014 Sep 28. doi:10.5539/gjhs.v7n2p71.
- Radzimińska A, Strączyńska A, Weber-Rajek M, Styczyńska H, Strojek K, Piekorz Z. The impact of pelvic floor muscle training on the quality of life of women with urinary incontinence: a systematic literature review. Clin Interv Aging. 2018;13:957-965. Published 2018 May 17. doi:10.2147/CIA.S160057.