www.incontinentsupport.org

I am male and 39 yrs old. This is long, I apologize. I have a history of depression and anxiety. About a month ago I had a panic attack at work due to the high level of stress at my job. My panic attacks are tightness in my chest and difficulty breathing that can last for days. I have them before and am used to them. This time during this episode I wet my pants at work. Historically I made frequent trips to the bathroom and am up 2-3 times a night to go, but I never had an accident before. Since this time I have had a difficult time holding my urine when I get very strong urges. I had a number of accidents since the first one and am now wearing absorbent underwear. Now daily, I get frequent, very strong urges to go. I can usually concentrate and stop the flow, but very often as soon as I relax after stopping the flow, a moderate amount of urine leaks out. After a strong urge if I went to the bathroom sometimes there really wasn't alot of urine in my bladder. I went to a urologist and my GP and had some tests run. I do not have Diabetes, my prostate is fine, my thyroid is fine and there is no infection The urologist says that this is due to stress and anxiety and will go away. I am being very patient with all of this and was wondering if any of you had any opinions about what I am going through. How long should I wait for it to go away before I start to pursue other options? Can stress/anxiety really cause incontinence? Is it possible that it may be permanent? Anyone else ever experience anything remotely like this?

I truly appreciate any response and thank you for your time in reading my long post.

Regards

I am really sorry to hear of your present problems which are obviously very challenging. You are obviously right to be wearing protection which, while it does not tackle the cause of the problem it certainly fixes the embarrassment problem! Whilst you are possibly right - that the problems are caused by stress at work, I did wonder if there might be anything else implicated.

Firstly, do you have any problems at all outwith your working day - either urges in daytime hours or leakage at night? I notice you say you get up 2 or 3 times a night so I assume that you do have some problems outwith work.

Secondly, since you mention depression and anxiety, do you take any medication for these conditions? Occasionally, such medication can bring on bladder problems.

Thirdly, could you sat what tests were run on you? The one that I would be thinking of as useful would be Urodynamic testing. This is a procedure where fine catheters are passed into the bladder to measure pressure and fill the bladder and it is very helpful in identifying what is going on in the bladder and spotting abnormal behaviour of the bladder muscle and the sphincters.

Apart from those things, and in the absence of a more specific cause, you are probably just going to have to work on catching the flow really. The absorbent pants are not that absorbent so you could consider diapers which really do hold a lot and use them to take away the anxiety caused by the leakage and, by doing so, reduce the stress levels. Who knows, it might even make things better.

Dear camping, Anxiety and stress rarely "just go away". Now that you have seen an MD and uroligist - a sensible first step - you should now find a mental health professional. Anxirty and stress can lead to a lot worst things than incontinence. In the mean time get and wear the best protection (pads, diapers, etc) you can and wear them faithfully - this will relieve some of the stress of wetting your self, but you have to try and seek help and indetify the cause of your mental pain. Believe me when I say depression/anxiety/ stress is more life threatening then anything else there is. Thye can also lead to many health problems. Seek help - we are here for you - talk openly with us we can help in at least one area and maybe more. Are you on any meds they may help your stress? If not talk to the doctor - this is not a cure but a tool in fighting to get better. We are here, good luck and use all the resources you can. Papa

Thank you for your responses. I have been struggling with depression and anxiety for over 10 years now and have been taking Welbutrin most of that time. I have tried pretty much every anti-depressant out there during this time and this is the only one where the side effects aren't worse than the original problem. I typically don't handle stress and pressure very well and the medication helps with that, but it doesn't eliminate it totally and I do an OK job coping.

The urologist did not perform any bladder tests when I saw him. He said that the problem was caused by stress/anxiety and the tests most likely would be inconclusive.

So how long should I wait before going back to the urologist? My wife and I talked about it and figure that I would handle it like I am until after the holidays. Then in Jan if the problem is still there I would go see the DR again.

One last question if I may. I have done alot of reading online about this and I don't read alot of positive things about the medications available to help with incontinence. Most of the responses I have read have said that the incontinence was only partial solved, still requiring protection or that the side effects were worse than having to wear protection. Do any of you have any thoughts on the medication?

Thank again.

Well, you are quite right about medications - they just give you a lot of other problems in place of the one you have and only partially work anyway. Besides, if the cause is the stress, then reducing the stress is really the only way to treat the problem. However, I have a couple of ideas for you ...

The first concerns emptying your bladder - do you do this on a regular basis? If you can manage to beat your bladder to it by, maybe, emptying it yourself in the loo very 2 hours, there is a good chance you could have it pretty empty so if you do have an urge it would only be a small amount and small amounts are easier to deal with . You would have to notice when things happen and see if there is a schedule you could set up to keep the bladder empty and stop if draining large volumes without warning.

The second is just another way of catching the output. Diaper are very popular in North America and seem to work well for many but large voids are very tough for a diaper so an alternative might be worth considering. We call the condoms or sheaths but in the USA they are called external catheters. These are self adhesive and roll over the penis and remain in place for 24 hours. You can attach a leg bag for daytime and a bigger bag for nighttime if needed. A 750ml leg bag would allow you to catch sudden voids and drain them out later. Have a look at http://www.us.coloplast.com/products/continencecare/pages/default.aspx to see the sort of things available. You can even order samples from them. I have been using their Optima sheaths at night for a while now and they work fine and use then in te day if I am going far from home too.

A final note - don't stop drinking enough and stronger urine will make things worse.

I was initially trying to beat the urge to the bathroom, but it became silly when I was going to the bathroom every 45 mins to an hour when an urge hit me. I was starting to wonder what my co-workers thought. (I work in a very small office) I try to go every 2-3 hours now. I still get urges in between these times where I try to fight it back but often times I leak. It's ok, at least I'm not making a mess of myself anymore. I spend alot of time on the phone with clients during the day and often times I cannot get to the bathroom in time so the protection is saving me during these times. It has been an emotional roller coaster over the past month during all of this and I think I am starting to relax alittle bit in regards to the need to wear protection. I'm not sure if I will every get to a point where my stress and anxiety are gone. Maybe having high amounts of stress/anxiety over the years has taken its toll on my body and the incontinence is the result. Who knows. I hope that the incontinence doesn't become one of those chronic things I have to deal with going forward kinda like having occasional panic attacks. I will adapt as needed, things can certainly be worse.

I think I have read almost every post on this forum and it has been very helpful to read them, everyone here seems pretty helpful.

Kind regards

Jason

Hi Jason,
I have been reading your posts, and the guys responses to you as well.
I do think that the thing you should do is find a suitable absorbent pad, as papa said earlier, i do think anything that helps ease the stress of the situation will be helpful, after all, having an accident while at work is quite stressful to say the least, i do know the stress of that myself as, i think plenty of the people here would as well.

stress doesn't just 'go away'.. unfortunately! if stress really is the cause of the incontinence problem, then i do think that you may need to address the factors of your life that cause you stress, i know easy to say right?
i think the things that cause stress that you can change, maybe change them? and the things you cant change for whatever reason, perhaps come at them from a different direction so they dont cause you stress.

I personally have come to realize lately that, life is all about change and adaption!

as for medications, i truely think that there are a lot of the medications used for treating incontinence have side effects that are often way worse than the problem they are meant to solve! Personally i have had nothing horrible results from the medications i have tried in relation to incon problems.


just my thoughts
mike

Hello Jason

I can relate to the sudden urges that you have.But mine is that I have lost some of the feeling that tells you when you need to go but mine is both sometimes.The wetting I deal with with no problem but bowel incontinence was another whole story.Thank God I have learned to control it most of the time but still well leak urine.Most of the time I do not lose total control if close to a rest room.As by the time I know I need to go I am about to the busting point.But when I gave in to diapers it made life a whole lot less stressful.
I see you like to camp.I do also.We pull a RV trailer and that was when I would all ways be thinking will I make it to a rest area or some where to stop as if you RV you know you cant just stop any where.So now I just all ways wear a over night diaper when on the road and it makes for a lot less stress free trip.