Working from Home Brings on Bladder Issues
Most of us don’t think about our bladder or urinary system until something goes wrong, like seeing blood in urine or suddenly, urgently needing toilets. We’re surprised when it happens, but incontinence and other bladder issues are relatively common.
And they’re showing up more and more as we’re back in public after years of extra time at home.
“Many patients with incontinence feel embarrassed by their problem,” says Doreen Chung, MD, a urologist at ColumbiaDoctors and assistant professor of urology at Columbia University Vagelos College of Physicians and Surgeons. “Because people feel embarrassed about their condition, they often do not share their problems with their families or friends. So no one knows how common the issues are, and how important they are to correct for comfort and health.”
Since workers have started returning to offices in greater numbers, Chung has seen an uptick in patients with urinary issues. We spoke to her about the most common issues she’s seeing.
Fixing habits acquired while working from home
Some people who spent a lot of time working from home have become conditioned to urinate more often.
“When people regularly urinate more often than necessary, this can disrupt the brain-bladder connection, making it more difficult to sense when the bladder is full or empty,” Chung says.
When people feel the need to urinate, but their bladders are not actually very full, they may have a problem called sensory urgency. Some people working from home also developed the habit of drinking large amounts of fluids. When your favorite coffee, tea, seltzer is immediately available, it is easy to consume constantly.
“For these people with sensory urgency, we use a treatment called bladder retraining,” Chung says. “We teach people to pee on a schedule that makes sense. We also have them fill out a diary of how much they are drinking and how much they are peeing. This helps to give them a sense of their fluid consumptions, as well as how full their bladder is when they have the urge to urinate.”
More serious issues masked by working from home
People who work from home are able to visit the restroom as often as they want, but this behavior can mask problems such as overactive bladder and stress urinary incontinence. As people return to the office or public outings in general, and bathrooms are not as accessible, bladder issues become more uncomfortable and obvious.
Overactive bladder means loss of control of urination, a sudden uncontrollable urge to urinate. Some people may leak urine before reaching the bathroom with an overactive bladder.
“Overactive bladder is different than sensory urgency because the bladder is actually contracting when the person feels that they need to urinate,” Chung says. “A normal bladder holds urine and does not contract when you do not want to urinate.”
With sensory urgency, one feels the urge to urinate, but the bladder is not actually contracting at the time, so leaks do not occur.
Overactive bladder can be treated with lifestyle changes and exercises, medication, biofeedback, injections, or nerve stimulation.
Stress urinary incontinence
Stress urinary incontinence is leakage of urine during moments of physical activity—such as coughing, sneezing, laughing, or exercise—that increases abdominal pressure.
“If the sphincter muscles that keep the bladder closed are weak, the increase in abdominal pressure can force open the bladder and urine can leak out,” Chung says.
At home, people could use the bathroom frequently to keep their bladder empty and avoid the problem. But returning to the office has changed the equation.
“Stress incontinence is a very common problem,” Chung says, “but pelvic floor muscle exercises and lifestyle changes can help. If not, office and surgical procedures can successfully treat the incontinence.”
Many people have what is called mixed urinary incontinence and have both stress incontinence and urgency incontinence (when people with an overactive bladder leak urine before reaching the bathroom). A urologist can make the correct diagnosis and treatment plan.
When to see a urologist
If you are bothered by urinary symptoms, such as frequency, urgency, urinary incontinence (leaking urine), or the sense of incomplete bladder emptying, see a urologist.
Signs and symptoms of bladder control issues
- Urinating more times than is typical for you
- Getting up frequently at night to urinate
- Accidentally peeing or leaking while coughing, lifting something, sneezing, working out, and other activities
- Not feeling the need to urinate until it’s very urgent
- Feeling the need to urinate and having to rush to the bathroom
- Leaking urine with the urge to urinate
Try this if bothered by urinary incontinence
Pelvic floor muscle exercises
Strengthening these muscles can prevent urine leaks caused by overactive bladder or stress incontinence, Chung says.
- Squeeze like you’re trying to hold in pee and feel your buttocks contract. All the pelvic floor muscles are connected together: If you squeeze one you squeeze them all.
- Hold squeeze for three seconds.
- Repeat that 10 times in a row at least five times a day (when you wake up, before breakfast, before lunch, before dinner, and before you go to bed).
For people with urgency, Chung says: “You can also try three quick repetitions of these exercises when you have the sudden urge to urinate. Sometimes this can make the urge to urinate go away.”
Doreen Chung, MD, is assistant professor of urology at Columbia University Vagelos College of Physicians and Surgeons and a urologist and urogynecologist at ColumbiaDoctors and NewYork-Presbyterian. She is board certified in female pelvic medicine (pelvic floor disorders include urinary and fecal incontinence, pelvic organ prolapse, overactive bladder, and urinary issues) and reconstructive surgery.