urge incontinence

I'm wondering if there is a distinction between true urge incontinence (as soon as you feel the need to go its too late) and the psychological connection between the need to go and hearing running water, or knowing that the bathroom is near after holding it in for a while. kwim?
I'm thinking there's a difference there, but I could be wrong. just my thoughts.

also I think I remember reading somewhere that urge incontinence is usually a sign of a neuromuscular issue unlike stress incontinence which is mostly an issue of physics (forces above the bladder overpowering the forces from below)

don't really know how to stop the annoying feeling other than emptying your bladder before washing the dishes and then (safely) ignoring any such feelings. but that's a guess.

I think the two are similar. The brain is hard-wired into the system of nerves that control the bladder. As we age, perhaps those nerves become stretched or otherwise attenuated a bit. Urge incontinence showed up in later years for me, but doesn't seem to be progressive. I may have it bad one day and then not notice it again for months. Sometimes it's hardly noticeable until I'm struggling with a zipper or whatever. That must be forebrain involvement.

but when I stand at the sink I spread my feet wide into second position and plie and rise on my toes.....
I have a theory that drinking all at once vs. drinking sips here and there is much better-
perhaps you are doing the dishes that magical 30 min after eating and what is actually going on is some pressure from digestion.

I think urge incontinence is partly neuromuscular, partly sound association (running water-wise), partly the condition of the urethra, partly blocking of nerve pathways.

I can no longer find the post I did on the neurophysiology of digestion, which describes what happens all along the digestive tract, both neurologically and physically. Suffice to say that it is very complex. I imagine that there are similar mechanisms happening with the kidneys and bladder. I *do* know that my daughter's totally dysfunctional continence, both bowel and bladder during the day, were cured at age 6, by chiropractic treatment which produced about 90% cure in 3 weeks, so there was something going wrong with the sensations she was not feeling. There are signals that there is urine in the bladder, subconscious signals to open the sphincter at the top of the urethra, presumably signals to close it again. There would be similar conscious signals for the bottom sphincter, ie Kegalling. If the fascia around the urethra is damaged (urethrocele) at the top, the top of the urethra is stretched into a cone shape, so the sphincter is not supported or may be damaged. Maybe it is possible to retrain it and drag in the purse strings again. Muscles all over the body that are continually stretched, and do not contract, lose tone and are then unable to contract.

There are also signals that the bladder is full and wants to empty (caffeine and other irritants accentuate this sensation). If the internal sphincter is not working properly or blown out into a urethrocele, all the work falls to the kink in the pipe formed by the cystocele and the voluntary bottom sphincter. There is a trigger point or some sort of pressure point under the nose, tight in against the roots of the top teeth. If you feel that full-bladder-wants-to-empty sensation, and you can press firmly there with a finger tip *soon enough*, it will stop the bladder spasming and the urge will go away for a minute or two, so you can get to the toilet. This works for me mostly, though as mentioned by Gmom, when I get inside the bathrooom door it is almost impossible to control!! I learnt about this point from our local Continence Nurse. I think Continence Clinics are a great resource, underutilised by people other than the very young and the very old.

I get UIC occasionally, usually after sitting in one place for a long time, usually driving, then getting up and moving around. I also find that I can sometimes short-circuit this urge when I get out of the car, which generates a lot of intraabdominal pressure with all the twisting and turning, especially if I grab a few things off the seat, and am trying to hold onto them, as well as extricating myself. If I remember, and I know I have a fullish bladder, I get out without anything in my hands and bend deeply from the hips to invert my bladder, then do a douple of kegels while I am down there to wake up the PF. I can actually feel them engaging. Once I can engage them I can control my bladder until I get inside. Christine, I think it is the contortion of doing up a zip that has the same effect as getting out of the car with parcels in the confined space of a parking bay.

As a woman with POP, my bladder continence is threefold. There is the aforesaid unconciously controlled, top urethral sphincter, then the pelvic floor muscles, the consciously0-controlled sbottom sphincter, but there is also the kink in the pipe which results from my bladder falling backwards. While I am sitting in the car immobile I am OK. Maybe the kink equalises the pressure on both sides of the urethral sphincter, so the internal sphincter thinks there is no internal bladder pressure, and relaxes, so I suddenly get the urge to pee when I stand up into posture and the kink straightens out.

I also think the idea of a cluttered bowel putting extra pressure on the bladder is logical too. Another reason for keeping everything moving.

Sorry this if this is a disjointed post. I have been all over the Net this morning checking stuff for it (and checking the Weather Bureau too, for DH. More rain on the way - hooray!!!) and some of it might be out of order, but I must get it posted anyway, and get out of my dressing gown, and on with the day's tasks.

Once again, I would stress the importance of getting to know pelvic anatomy and physiology and interlacing it with your experience of your own body, and figuring out what is happening in your own body in relation to how it functions. How lucky we are to have the Net and to be able to read!!

Cheers

Louise