I have a WEE problem …
There I said it out loud!!! All jokes aside, there’s no doubt that bladder control can become more difficult as you get older. Currently an estimated 4 million Australians suffer from bladder control problems and women are much more likely to suffer from incontinence. Most issues can be diagnosed, treated and cured but getting the help you need is really important. And there’s nothing to be ashamed of either!
After having my last child as an emergency C-section 18 years ago, rare complications meant I also had to have an emergency hysterectomy. The placenta had grown through the wall of the uterus and entered my bladder – a condition called Placenta Percreta. It has a high mortality rate and is not usually picked up until either the uterus silently ruptures or during childbirth when the Obstetrician goes to remove the placenta and cannot find it. Not much is known about why this phenomenon occurs but previous extensive gynaecological surgery is thought to be one of the causes.
The placenta was eventually removed via the hysterectomy and my bladder was stitched up and urinary catheter inserted but at the six-week check up tests confirmed a vesico-vaginal fistula – a hole between the bladder and the vagina – which rendered me incontinent – at the age of 36. I had major repair surgery when Olivia was 9 weeks old to repair it and only afterwards did I find out the failure rate is extremely high. I was very lucky, other ladies not so.
Unfortunately as a result of the surgery some vaginal tissue was left in my bladder wall during the repair. It cannot be removed and I’ll need to take daily medication for life because my bladder sees the vaginal tissue as a foreign body and attacks it, resulting in frequent urinary tract infections.
Because of the surgery and need to wear a catheter for a long time I had to undergo bladder retraining. My bladder was very unhappy at this point because of nerve damage from the surgery. Essentially I had to increase my water intake and learn to ‘hold on’ gradually teaching my bladder how to hold more fluid, I had to measure all urine output in a jug and write it down in my ‘bladder diary’. It was bloody hard let me tell you.
FUNNY FACT: After months of keeping a bladder diary and measuring my wee into a jug, I can still tell exactly how much I am holding in my bladder. Even 18 years later! It makes for a good party story that’s for sure!
The bladder is an absolutely unique organ, unlike any other in the body. It is specially lined to protect the cells beneath it and protect them from infection. Stretch receptors in the bladder tell the nervous system when its time to go to the toilet and they all talk to each other to maintain the integrity of this amazing organ.
The lining of the bladder is not found anywhere else in the body, hence the need to keep it healthy. It is absolutely unique and lined with transitional epithelial tissue which will expand the bladder as it fills.
WHAT I LEARNED ABOUT THE BLADDER
- The bladder is a hollow muscle pump. It fills slowly from the kidneys, and can hold one and a half to two cups of urine (300 to 400mls).
- Adults should only go to the toilet a maximum of 6-8 times a day and sleep through the night without getting up to go to the toilet.
- Two litres of water a day is absolutely imperative for bladder health. And the absolute bonus is that it keeps your skin nice and clear as well.
- Don’t fall into the trap of going to the toilet before you leave the house ‘just in case’. Only go the toilet when you need to (see why below).
- Your bladder is a muscle. If you empty it more frequently it will shrink and hold less (called reduced bladder capacity).
- Incontinence can happen at any age. My surgeon sees patients in their early 20s.
- Coffee, tea, alcohol and coca cola are known bladder irritants. If you have a sensitive bladder, these may affect you.
- A leaking bladder will not go away by itself. One in 3 women who have had a baby will leak urine from time to time. This is usually the result of weak pelvic floor muscles and is totally treatable.
Urinary tract infections are extremely common and some women are more susceptible than others. If you are one of them – know the signs and treat ASAP.
MENOPAUSE AND YOU
Unfortunately menopause can cause havoc with your bladder (and bowel).
As the hormone levels slowly drop, lack of elasticity in your surrounding tissues such as the vagina and the bladder can cause hypersensitivity, leaking, vaginal dryness, pelvic floor issues and increased urinary tract infections. This is what happened to me recently even though I am on HRT.
Fact: Persistent UTIs can be a warning sign that something is wrong, it could be a structural issue such as a prolapse or something as minor as a change in vaginal pH levels. If in doubt see your GP and get a referral.
There are also medications that you can use such as vaginal pessaries, which are inserted at night, the ones I use are called Vagifem. These help keep the tissues supple and moist. I also take Vesicare for my overactive bladder, it is brilliant for overactive bladders and whilst they are expensive ($50 – $90 a month) you can claim it on private health insurance.
Hormone Replacement Therapy (HRT) in either patches or tablets is another option – something I have to stay on to keep my bladder functioning. It’s not for everyone but it’s worth discussing with your GP.
URINARY TRACT INFECTION TIPS:
- If you suspect you have a urinary tract infection go to your GP. Don’t self diagnose. Many ladies have ended up in hospital with a kidney infection as a result.
- Once you get to your GP, ask the receptionist for a urine spec container and fill with mid-stream urine for your GP to test.
- If your GP’s dipstick test shows possible infection, make sure the sample is sent off to pathology (many GPs do not send the test off – make sure yours does). The sample will be tested and if it’s positive, they will check the infection sensitivity against known UTI antibiotics. This will ensure that you are taking the antibiotics specific or sensitive to your infection.
- Take the full course of antibiotics (and probiotics as well).
- Go back and get retested a couple of days after you finish the antibiotic course – to make sure you are clear of infection. This is especially important if you get them frequently. It’s important to know whether you are relapsing with the same infection or you just have a recurrence of UTIs. The difference is important.
- Recent research has shown that untreated UTIs (by antibiotics) over 14 days can result in the bacteria changing the lining of the bladder making re-infection more possible and harder to get rid of. You don’t want that, trust me.
- See your GP again is symptoms persist (yes I know that sounds like an advertisement… BUT you guys… UTIs can linger around in the background ok?)
So I hope this has helped you with your plumbing issues. When I was going through all this I found the doctors often didn’t explain any of the information listed above. Sometimes ya just gotta hear it from another chick!
If you have any questions feel free to ask!
PS BIG thanks to Greg Guillemin for creating the ‘Secret life of heroes – The ordinary life of Super Heroes’ illustrations you see here. You can find more of them on Pinterest.