Patient: I am a teenage boy, and I sometimes wet myself a little when I cough or lift heavy objects. I used to hold my pee for very long periods, up to 16 hours, and I never used the school restrooms. I have always dribbled when I needed to go really bad. I am not particularly worried about the cause, but sometimes when I have a cough, or blow my nose, the leakage can be noticeable. Is there anything I can do to hide that I wet myself? I put paper towels in my underwear at home, but they are too noticeable to wear to school. What should I do?
Doctor: Hi welcome to Ask The Doctor,It’s usually due by weakness of the muscles of the pelvic floor, which support the base of the bladder. This means that when you cough or sneeze, which puts pressure on the bladder from above, the base of the bladder drops down. This puts a strain on the sphincter muscle at the exit from the bladder, which instead of staying closed opens up very slightly, leading to leakage of urine. Alcohol makes the problem worse because it can irritate the muscles of the bladder and send them into spasm, making you want to pee more frequently than normal. Coffee (especially if it’s strong) can have the same effect. Pelvic floor exercises can help you to overcome this problem. You can also get help with pelvic floor exercises from a physiotherapist or continence advisor. Once you know how to do the exercises you can do them at home, while you are doing other things, like the ironing, or even watching television, and no-one else will ever know! Pelvic floor exercises don’t work instantly, and you will have to do them up to 20 times a day for at least a couple of weeks before you notice any real change.Hope this helps. All the best.