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Cracking the Code of Urinary Incontinence: Unveiling the Secrets of Silent Bladders

"I experience constant urine leakage throughout the day without feeling the need to urinate. In some cases, the bladder begins to empty without any warning. Alternatively, I may not experience an urge to go, but I do feel pressure and discomfort in my lower abdomen.

For instance, when I'm sitting in a chair, whether watching TV or working on the computer, I don't feel the urge to urinate until I stand up, often requiring me to rush to a toilet. You might recognize these issues or think, 'But they never felt the urge.' If I had a dollar for every time I heard someone say, 'I didn't feel the urge,' I'd be receiving tips daily.

As I frequently explain, just because you choose to drive a car without wearing glasses and ignore another car causing an accident, it doesn't mean the car wasn't there; your eyes just didn't register it. Similarly, for diminished hearing, you wear hearing aids. So, are you certain that your bladder will always function properly and signal you in time? You may think so, but like eyes and ears, bladders are organs that can malfunction or be affected by factors like aging or diseases such as diabetes.

Let's consider Lorraine, a 74-year-old who used to be a teacher. She could go for hours without needing to empty her bladder or experiencing leaks. However, one day, while shopping at Home Depot, her bladder emptied without any prior urge. She had gone without urinating for five hours despite drinking water. When I explained that her bladder had been ignored for years and now it was ignoring her, she responded with the usual refrain, 'But I didn't feel the urge.'

It's worth noting that Lorraine wears glasses.

Then there's Elizabeth, 67 years old, who would spend hours communicating with friends and family on the computer. While sitting, her pelvic and abdominal muscles would naturally keep the urethra closed, allowing her to stay dry for hours without feeling the urge to urinate. However, as soon as she stood up, there was no time to make it to the bathroom. Elizabeth became extremely frustrated and angry since her bladder provided no warning, and she didn't have the time to act on it. When it was suggested that she should have considered emptying after sitting at her computer for 2.5 hours, she replied, 'I do not get an urge.'

The issue of continuous leakage is often different, and the bladder may not completely empty when attempting to urinate on the toilet. Using a watch to time voiding won't be very helpful in such cases.

It's not just nurses, teachers, and doctors who tend to delay emptying their bladders. There are also non-professional reasons to disregard your bladder's signals.

Many people misinterpret the recommendation to drink eight glasses of water as 'the more, the better.' A healthy bladder can typically hold up to 16 ounces. However, if you drink 16 ounces every hour and don't feel like going to the bathroom repeatedly, you'll start ignoring the bladder's signals to empty. When you ignore your bladder, it may eventually start ignoring you, leading to unexpected leaks in places like department stores, cars, or the office.

If you drink 8 ounces of water, it will generally be in your bladder within 20 minutes. So, it's a good idea to plan your restroom breaks if your bladder doesn't give you the warning signal. Additionally, there's no health benefit to consuming large volumes of water. Drinking more than 12 ounces at once is excessive. I've seen many cases of excessive urine output on 24-hour diaries, which can lead to various problems. While daily exercise is healthy, excessive water intake is not. 'I never heard that drinking a lot of water is not healthy for me.' Well, this might be the first time you've heard it, so it's worth giving it a try to see if it's related to your urinary leakage.

For example, Kathy, aged 54, had been experiencing brief blackouts for years, and the cause was unclear. However, after reviewing her 24-hour urine diary and observing her high fluid intake, it was evident that her excessive fluid consumption was the issue. Kathy was producing 4 quarts of urine per day. She thought she needed surgery for her leakage but, I convinced her to reduce her fluid intake and plan her restroom visits – 10 ounces in, bathroom within 30 minutes.

Kathy, who initially resisted the suggestion, returned delighted. She hadn't experienced any more leakage or blackouts since cutting back on her fluid intake. She said, 'Doctor, I thought you were crazy, but you've made me very happy. I'm dry without any surgery.'

Sometimes, simple adjustments to our daily activities and habits can make a significant difference. If you're struggling with incontinence, your solution or improvement may be easier than you think. If you drink a normal amount of fluids and regularly use the bathroom but still experience leakage, don't hesitate to seek help at Central Florida UroGynecology in Rockledge, where we can treat a range of urinary issues, even if you've never felt the urge."

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