Incontinent

[carolineamcleish@yahoo.com]

I am peri-menopausal and in remission with breast cancer, I cough I pass water, I sneeze the same, I get up through the night to go to the toilet and still wet the bed somehow. I can get up in the morning and go to the toilet, then jump in the shower and before the shower is finished I can urinate at least twice. If I go out I wear pads. and don't feel the need to go but as soon as I unlock my door I need to go straight to the toilet and I don't always get there in time.

[Elaine Hazell]

It sounds like you may have what is called mixed incontinence. That means stress & urge incontinence . Firstly stress incontinence is when you leak urine with raised abdominal pressure i.e coughing, laughing, sneezing etc. It is usually found in ladies that have had children or are overweight. The first line treatment is pelvic floor exercises to strengthen the muscle .There are leaflets on how to do this on Guys & St Thomas web site.If you are having trouble performing them ask your GP to refer you to either a physiotherapist or continence advisor & in most areas you can refer yourself.There are also apps that you can down load to your phone that show you how to do them.type ein pelvic floor or kegel exercises.
The second symptom sounds like you may have an "overactive bladder ". The pressure within the bladder should not change when the bladder is filling. The pressure rises when you get to a safe place to pass urine & the bladder empties. If the bladder is overactive bladder the pressure rises even if you only have a small amount of urine in there & the urine leaks out. You descirbe what we refer to as "key in the door" . So when you get to home youre in a safe place but you leak as soon as you get to the front door. The first line treatment is lifestyle modifications. Avoid drinking fluids that contain caffiene such as tea & coffee & fizzy drinks. Drink 1 1/2 litres of fluid spread out throughout the day as concentrated urine will also irritate . Pelvic floor exercises will also help stop the leak. There are also medications called antimuscaranics that can help stop the bladder pressure rising when it shouldnt.
If you feel any bulges in your vagina or rectum this could indicate a prolapse. I would visit your GP for an examination & to discuss your symptoms.