Have the ever felt the urge to urinate when you turned your key in the door? Although you may not believe it, you are not alone.
Latchkey incontinence is actually a type of urge incontinence, a condition defined as a sudden urge to urinate followed by an involuntary loss of urine. The condition is sometimes known as “detrusor instability” or “spasmodic bladder”. Those with urge incontinence may need to urinate frequently throughout the day, often also through the night. Urges “to go” can be triggered by bizarre things such as a tap running or the sound of the rain. In the case of latchkey incontinence, people get this sudden urge when they turn the key in their door, knowing they are a short walk from the toilet. This sudden urgency is known to be just as debilitating as the actual incontinence. Professor Malone Lee asserts, “it has been shown that urgency, just as much as incontinence, affects patient quality of life adversely.”
The world of urge incontinence sufferers is one full of toilet mapping and racing to public bathrooms. Planning a day where your bladder does not take the driving seat can be hard. It is not surprising that latchkey incontinence can cause isolation, fear of being away from a toilet and even depression. 55 year old Catherine states, “I would only leave the house if I needed to, and my life was a constant battle between having fun or staying near a toilet. Specific things could set it off, such as turning a key in a lock. It sounds stupid but it really can ruin your life if you let. Until I visited a Doctor, I felt completely alone.” Many people with urge incontinence even report that the amount of urine they leak is much larger volumes than what is reported by those with stress incontinence. So, what can cause this latchkey phenomenon?
Lets look at the science first.
Ultimately, urge incontinence is caused by abnormal bladder contractions.
In individuals with urge incontinence, the muscles of the bladder contract with enough force to override the sphincter muscles of the urethra. This is the tube that takes urine out of the body. For this to occur, a condition, nerve damage or weakening of muscles has to trigger this.
The Causes and Risk Factors
The risk of the muscles overriding the sphincter muscles in women can be increased by a number of lifestyle and physical factors. For women, the likelihood of latchkey urgency increases with age, pregnancy and menopause. Other common reasons for types of urge incontinence are the following:
- Damage to the nerves of the bladder. The condition is known to be linked to Stroke, Parkinson’s, Multiple Sclerosis and other conditions that effect the brain’s ability to send messages to the bladder via the spinal cord.
- Irritation to the bladder. Infections such as urinary tract infections can cause the bladder to become irritated and increases the sense of urgency.
- Constipation. Being constipated can cause a number of problems for the bladder. It can lead to concentrated urine, which can irritate the bladder. A full bowel can also press on the bladder, making incontinence urges worse. To avoid constipation, increase your soluble and insoluble fibre intake.
Additional risk factors for developing urge incontinence include the following:
- Late Adulthood
- Having a prostatectomy
- Having severe injury to the bladder
Latchkey Incontinence and the Brain
In addition to the general science of why the bladder muscles contract, latchkey urgency can also be a force of habit. Some specialists argue that we can easily associate objects to actions. Psychotherapist Ginnie Love asserts, “the mere glance of an object that we relate to an action can jump start the brain's process to a more urgent need to experience it, all subconsciously. This is much like the training of a dog or cat.” This theory makes sense when we compare our urgencies to the feeding of a pet. If you tap a spoon on a bowl frequently before feeding your dog, your dog will associate that with feeding time and will likely become hungry. A study completed at the University of Utah found that relaxing the mind may be powerful when it comes to reducing bladder urge issues. Recently, Doctors at Loyola University Health System conducted a clinical trial using cognitive therapy for those with urge incontinence. They found cognitive therapy and practicing calming the mind, to be an effective management strategy. Being aware of the association between turning a key and toileting can help prevent this pattern.
Light Urge Incontinence Products
Heavy Urge Incontinence Products
In the UK, 24% of older people are affected by urinary incontinence!
What Do Specialists Recommend?
- Cut down on the caffeine. It is known for the condition to become worse after consumption of bladder irritants such as caffeine in tea, coffee and fizzy drinks. If you do struggle from
- Wait a few minutes. Do not got to the toilet as soon as you get in the house. Train yourself to wait a few minutes before visiting the toilet, so that this becomes easier and easier. Specialist Alia Hoyt states, “train yourself to wait five minutes more and then longer over time. Filling it with more urine stretches it and allows it to hold more”.
- Relax the mind. Although you need to consider what you are putting in the body, you also need to control the mind. Taking deep breaths and trying to rid the sense of “panic” can also calm your bladder. It has been shown that stress and incontinence are actually often linked.
- Treat the brain as a muscle. Think of the brain as a muscle that requires nurture to function properly. Provide it with healthy food, regular exercise and hydration. In fact, a study has shown that drinking too little fluid promotes infection and can worsen incontinence urges!
- Practice Pelvic floor Exercises. You have probably heard of pelvic floor exercises and considered them a waste of time in comparison to incontinence surgery. However, they can and do work for latchkey incontinence with patience. Read about how to do pelvic floor exercises here.