Incontinence "cure" has problems

As others have noted here, some of us RP pts stay driest when our
bladders are fairly full. We've observed that our remaining sphincter
seems to function best, apparently because it gets a stronger
contraction signal, when we gotta go. So we drink lots of fluids, and
hold it until we just aren't willing to wait any longer. Fortunately,
the urge dissipates after an hour or two, so we can wait a long time
without discomfort. Then we void, followed by an hour of dribbling
because, we presume, the signal is weaker. But overall our pads stay
much drier this way, especially during physical exertion. I could
probably stay almost dry this way 24/7 if I sat down after voiding until
I needed to go again.

Alas, my uro shot this technique down on several counts.
1. It stretches our bladders, ultimately permanently, to the point they
lose elasticity and can no longer empty well.
2. It makes our bladders work too hard -- they ARE muscular, after all
-- toughening them like shoe leather and contributing to overactive
bladder problems (needing to go far too often and far too urgently even
when not really full).
3. Urine retention promotes urinary tract infections, which can be VERY
tough to cure.
4. It overworks and tires the sphincter, which explains why we dribble
after holding back a full bladder for a while.

He emphasized moderation in the frequency and degree of this approach.
So, since slings and gadgets don't seem justified for light-to-moderate
incontinence, I guess it's time we prolonged dribblers get serious about
our Kegels (I never formed the habit) and/or just live with pads or
diapers. I'm out of other ideas.

Damn! I can stay dry for many hours of heavy gym work (except on the
trampoline) or while changing from summer to winter tires, probably
because those are controlled and predictable activities (although I
don't think about continence in the gym). But in sports my mind and body
are 100% occupied, so my sphincter is just along for the ride and my
bladder seems plumbed directly to my pants.

I.P.

I.P. Freely wrote:
> As others have noted here, some of us RP pts stay driest when our
> bladders are fairly full. We've observed that our remaining sphincter
> seems to function best, apparently because it gets a stronger
> contraction signal, when we gotta go. So we drink lots of fluids, and
> hold it until we just aren't willing to wait any longer. Fortunately,
> the urge dissipates after an hour or two, so we can wait a long time
> without discomfort. Then we void, followed by an hour of dribbling
> because, we presume, the signal is weaker. But overall our pads stay
> much drier this way, especially during physical exertion. I could
> probably stay almost dry this way 24/7 if I sat down after voiding until
> I needed to go again.
>
> Alas, my uro shot this technique down on several counts.
> 1. It stretches our bladders, ultimately permanently, to the point they
> lose elasticity and can no longer empty well.
> 2. It makes our bladders work too hard -- they ARE muscular, after all
> -- toughening them like shoe leather and contributing to overactive
> bladder problems (needing to go far too often and far too urgently even
> when not really full).
> 3. Urine retention promotes urinary tract infections, which can be VERY
> tough to cure.
> 4. It overworks and tires the sphincter, which explains why we dribble
> after holding back a full bladder for a while.
>
> He emphasized moderation in the frequency and degree of this approach.
> So, since slings and gadgets don't seem justified for light-to-moderate
> incontinence, I guess it's time we prolonged dribblers get serious about
> our Kegels (I never formed the habit) and/or just live with pads or
> diapers. I'm out of other ideas.
>
> Damn! I can stay dry for many hours of heavy gym work (except on the
> trampoline) or while changing from summer to winter tires, probably
> because those are controlled and predictable activities (although I
> don't think about continence in the gym). But in sports my mind and body
> are 100% occupied, so my sphincter is just along for the ride and my
> bladder seems plumbed directly to my pants.
>
> I.P.

On your point #1 - my uro told me that EVERYONE should urinate every 3
hours whether they feel they need to or not (other than during sleep)
to prevent stretching the bladder and losing elasticity.

Ditto. I noticed for many years pre-op that when I tried to empty my
bladder first thing in the morning, all went well except that I would
feel the urge to void again 10 to 20 minutes later and that I could
dump quite a stream the second time. I was told by my doc that the
bladder fills and stretches during the seven or so hours of sleeping so
that the muscle is stretched to its limit and weakened by the time I
got up in the morning and that it was unable to fully contract with the
first emptying. Worked fine the rest of the day.
Dave Perry
james_wv@hotmail.com wrote:
> I.P. Freely wrote:
> > As others have noted here, some of us RP pts stay driest when our
> > bladders are fairly full. We've observed that our remaining sphincter
> > seems to function best, apparently because it gets a stronger
> > contraction signal, when we gotta go. So we drink lots of fluids, and
> > hold it until we just aren't willing to wait any longer. Fortunately,
> > the urge dissipates after an hour or two, so we can wait a long time
> > without discomfort. Then we void, followed by an hour of dribbling
> > because, we presume, the signal is weaker. But overall our pads stay
> > much drier this way, especially during physical exertion. I could
> > probably stay almost dry this way 24/7 if I sat down after voiding until
> > I needed to go again.
> >
> > Alas, my uro shot this technique down on several counts.
> > 1. It stretches our bladders, ultimately permanently, to the point they
> > lose elasticity and can no longer empty well.
> > 2. It makes our bladders work too hard -- they ARE muscular, after all
> > -- toughening them like shoe leather and contributing to overactive
> > bladder problems (needing to go far too often and far too urgently even
> > when not really full).
> > 3. Urine retention promotes urinary tract infections, which can be VERY
> > tough to cure.
> > 4. It overworks and tires the sphincter, which explains why we dribble
> > after holding back a full bladder for a while.
> >
> > He emphasized moderation in the frequency and degree of this approach.
> > So, since slings and gadgets don't seem justified for light-to-moderate
> > incontinence, I guess it's time we prolonged dribblers get serious about
> > our Kegels (I never formed the habit) and/or just live with pads or
> > diapers. I'm out of other ideas.
> >
> > Damn! I can stay dry for many hours of heavy gym work (except on the
> > trampoline) or while changing from summer to winter tires, probably
> > because those are controlled and predictable activities (although I
> > don't think about continence in the gym). But in sports my mind and body
> > are 100% occupied, so my sphincter is just along for the ride and my
> > bladder seems plumbed directly to my pants.
> >
> > I.P.
>
> On your point #1 - my uro told me that EVERYONE should urinate every 3
> hours whether they feel they need to or not (other than during sleep)
> to prevent stretching the bladder and losing elasticity.