What is LBL?

UL is when urine leaks out before you can get to a bathroom. If you have urinary leakage, you are not alone. Millions of women have this problem, especially during pregnancy, after childbirth and during menopause. Also known as ‘Light Bladder Leakage (LBL)’ or ‘Urinary Incontinence’ depending on the frequency and amount of leakage.

Some women may lose a few drops of urine when they cough or laugh. Others may feel a sudden urge to urinate and cannot control it. Urine loss can also occur during sexual activity and can cause great emotional distress.

What causes LBL?

Just as no two women are alike, there's no single reason that LBL happens. Some of the most common things that lead to uninvited leaks include:

• Stress incontinence — Leakage happens with coughing, sneezing, exercising, laughing, lifting heavy things, and other movements that put pressure on the bladder. This is the most common type of incontinence in women. It is often caused by physical changes from pregnancy, childbirth, and menopause. It can be treated and sometimes cured.
• Urge incontinence — This is sometimes called "overactive bladder." Leakage usually happens after a strong, sudden urge to urinate. This may occur when you don't expect it, such as during sleep, after drinking water, or when you hear or touch running water.
• Functional incontinence — People with this type of incontinence may have problems thinking, moving, or speaking that keep them from reaching a toilet. For example, a person with Alzheimer's disease may not plan a trip to the bathroom in time to urinate. A person in a wheelchair may be unable to get to a toilet in time.
• Overflow incontinence — Urine leakage happens because the bladder doesn't empty completely. Overflow incontinence is less common in women.
• Mixed incontinence — This is 2 or more types of incontinence together (usually stress and urge incontinence).
• Transient incontinence — Urine leakage happens for a short time due to an illness (such as a bladder infection or pregnancy). The leaking stops when the illness is treated.

Many women do not want to talk to their doctor about such a personal topic. But UL is a common medical problem. Millions of women have the same problem. Many have been treated successfully. Your doctor has probably heard many stories like yours.

Even if you feel shy, it is up to you to take the first step. Some doctors don't treat bladder control problems, so they may not think to ask about it. They might expect you to bring up the subject.
Family practitioners and internists can treat bladder problems. If your doctor does not treat such problems, ask for help finding a doctor who does, such as a urologist, OB/GYN, or urogynecologist.

Here are some questions to ask your doctor:

• Could what I eat or drink cause bladder problems?
• Could my medicines (prescription and over-the-counter) cause bladder problems?
• Could other medical conditions cause loss of bladder control?
• What are the treatments to regain bladder control? Which one is best for me?
• What can I do about the odor and rash caused by urine?

It also helps to keep a bladder diary. This means you write down when you leak urine. Be sure to note what you were doing at the time, such as sneezing, coughing, laughing, stepping off a curb, or sleeping. Take this log with you when you visit your doctor.

Schedule a visit with your doctor. Your doctor will ask you about your symptoms and take a medical history, including:

• How often you empty your bladder.
• How and when you leak urine.
• How much urine you leak.

Your doctor will do a physical exam to look for signs of health problems that can cause incontinence. Your doctor also will do a test to figure out how well your bladder works and how much it can hold. For this test, you will drink water and urinate into a measuring pan. The doctor will then measure any urine still in the bladder. Your doctor also may order other tests such as:

• Bladder stress test — During this test, you will cough or bear down as the doctor watches for loss of urine.
• Urinalysis — A urinalysis tests your urine for signs of infection or other causes of incontinence.
• Ultrasound — Sound waves are used to take a picture of the kidneys, bladder, and urethra.
• Cystoscopy — A doctor places a thin tube connected to a tiny camera in the urethra to look at the inside of the urethra and bladder.
• Urodynamics — A doctor places a thin tube into your bladder and your bladder is filled with water. The doctor then measures the pressure in the bladder.

Your doctor may ask you to write down when you empty your bladder and how much urine you produce for a day or a week.

There are many ways to treat UL. Your doctor will work with you to find the best treatment for you.

Types of treatments include:

• Behavioral treatments
• Medicines for bladder control
• Devices
• Nerve stimulation
• Biofeedback
• Surgery
• Catheterization

Behavioral treatments

By changing some basic behaviors, you may be able to improve your UL. Behavioral treatments include:

1

Pelvic Muscle Exercises (Kegel Exercises)

Exercising your pelvic floor muscles regularly can help reduce or cure stress leakage. A doctor or nurse can teach you the right way to do the exercises if needed. A pelvic floor physical therapist may be available in your area to help teach you how to strengthen these muscles or help you with other treatments. To do Kegel exercises:

1. First, try practicing these exercises while lying down.
2. Squeeze the muscles in your genital area as if you were trying to stop the flow of urine or trying to stop from passing gas. Try not to squeeze the muscles in your belly or legs at the same time. Try to squeeze only the pelvic muscles. Be extra careful not to tighten your stomach, legs, or buttocks.
3. Relax. Squeeze the muscles again and hold for 3 seconds. Then relax for 3 seconds. Work up to 3 sets of 10 repeats.
4. When your muscles get stronger, try doing your exercises while sitting or standing. You can do these exercises any time, while sitting at your desk, in the car, waiting in line, doing the dishes, etc.

See your doctor, nurse, or physical therapist to learn how to do these exercises correctly. Kegel exercises are most effective when the patient has received proper instruction from a health care professional. Simply trying to stop your urine flow or trying to do the exercises hundreds of times a day without instruction from a health professional will not help.

2

Bladder Retraining

You may regain bladder control by going to the bathroom at set times, before you get the urge to urinate. You can slowly increase the time between set bathroom trips as you gain control.