COPD and incontinence

When urine (wee) leaks out at any time other than when you are going to the toilet it is known, medically, as urinary incontinence. If this happens when you are coughing, laughing or sneezing it is known as stress urinary incontinence, because the muscles that control the bladder are under pressure.1 You might recognise the feeling of tensing your muscles in preparation for a sneeze.

Unfortunately, stress incontinence is more common in people with COPD and, despite the impact on quality of life, is under-diagnosed.2 There are several things that increase your chance of having stress incontinence, including your coughing, but the exact causes are not known.2

Although stress incontinence is more common in women due to the female anatomy and pressures of childbirth, it can occur in both men and women.1

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Add this to your discussion list as a handy reminder to discuss this with your doctor, nurse or pharmacist at your next appointment.

What can you do?

Your bladder is controlled by your pelvic floor muscles and strengthening them can help if you have urinary incontinence.3 You can also consider ways to reduce your need to urinate (see more below) and check your treatments with your medical team to ensure your coughing is as controlled as possible.4

Stronger muscles for a stronger bladder

Pelvic floor exercises can be done anywhere and are relatively simple,5 but if you are unsure speak to your healthcare professional and they can check you are doing them correctly or refer you to physiotherapy.

Finding your pelvic floor muscles

Unlike your leg or arm muscles, the idea of exercising a muscle you might never have thought about before can be tricky. The first step is to make sure you can feel which muscles you need to work on.

While you are having a wee, try and stop yourself.3 That tightening is what you need to feel when you are doing your exercises. It’s important that you don’t stop yourself from weeing regularly as you could end up harming your bladder.3

Exercising your pelvic floor muscles

Now that you’ve found the muscles, the next step is to give them a workout. You can do this first exercise whenever you are sitting comfortably, so try and build it into your day. Sitting in a waiting room or having your hair cut, no one else will ever know!

If you are feeling more able or have more time, you can try another exercise:6

To help avoid any stress incontinence during your day, try to tighten your pelvic floor when you feel a sneeze or cough coming on, or before you do anything physical that puts strain on these muscles, such as lifting something heavy.6

It can take a few months for your muscles to strengthen and for you to notice improvements, so stay positive and keep on squeezing!3

Manage your coughing

Your medical team will be making sure your medications are appropriate for you, but if you are experiencing stress incontinence you should discuss this with your healthcare professional and see if there is anything else they can do to minimise your coughing. They may be able to recommend an airway clearance technique that reduces the amount of coughing required to clear your chest.4

Get support

If you are experiencing stress incontinence you might feel that it is also adding to the mental pressures of coping with your COPD. You may be embarrassed or feel awkward talking about it. However, being open about your experiences with your healthcare professionals and people you know with COPD can encourage others to seek help and provide the reassurance that you are not suffering alone.

Use your discussion list to remind you to mention incontinence at your next appointment.

Want to discuss this topic in your next appointment?

References

  1. MyLungsMyLife. Stress urinary incontinence and COPD. Available at: https://mylungsmylife.org/topics/group-1/stress-urinary-incontinence-and-copd/stress-urinary-incontinence-and-copd/
  2. Battaglia S, et al. Urinary Incontinence in Chronic Obstructive Pulmonary Disease: A Common Co‑morbidity or a Typical Adverse Effect? Drugs Aging 2019; 36:799–806.
  3. NHS. What are pelvic floor exercises? Available at: https://www.nhs.uk/common-health-questions/womens-health/what-are-pelvic-floor-exercises/
  4. MyLungsMyLife. Stress urinary incontinence in COPD – what can you do? Available at: https://mylungsmylife.org/topics/group-1/stress-urinary-incontinence-and-copd/stress-urinary-incontinence-in-copd-what-can-you-do/
  5. Chartered Society of Physiotherapy. Pelvic floor exercises. Available at: https://www.csp.org.uk/conditions/incontinence/exercise-advice-incontinence
  6. MyLungsMyLife. Pelvic floor exercises. Available at: https://mylungsmylife.org/topics/group-1/stress-urinary-incontinence-and-copd/pelvic-floor-exercises/
  7. NHS. Urinary tract infections. Available at: https://www.nhs.uk/conditions/urinary-tract-infections-utis/