Let’s Talk Plumbing

(or abdicating my title as queen of CIGBOT)

By Marilyn L. Pinsky

They say as you get older you need to stay active.

So I decided to take up a new sport.

Actually I sort of invented it and unlike tennis or pickleball, you don’t need a partner, court time or even lessons to play. Not even an actual outfit, though maybe a couple of extra underpants wouldn’t hurt.

I sort of invented CIGBOT, a sport that unlike tennis or pickleball, doesn’t require a partner, court time or even lessons to play. Not even an actual outfit, though maybe a couple of extra underpants wouldn’t hurt.

It is called CIGBOT and I was almost nationally ranked at one point. In CIGBOT (short for “Can I Get To the Bathroom On Time?”) I was competitive in not just one, but in four different categories:

1. The ‘long dash to the main bathroom without use of hands’
2. The ‘quick waddle to the guest bath with use of hands’
3. The ‘less than three dribbles, but no more than five’ before reaching my objective
4. The ‘after one cup of coffee with a sneeze coming on’ category, which is where I really excelled.

In an effort to become less competitive, I started out my quest with physician Elizabeth Ferry, assistant professor of urology at SUNY Upstate Medical University.

“Leakage is one of the most common issues that bring both men and women to see urologists,” said Ferry. “Our goal is for your bladder not to control your life but to make it work with you.”

What about the mechanics of the situation?

“The bladder’s job is to stretch and contain urine until the point of a socially acceptable time that you want it to empty,” she said.

“Men and women leak for some of the same, as well as for different, reasons,” explained Ferry. What we do first is to search for the cause of your particular situation. With men, a common cause is an enlarged prostate gland. Just imagine that there is a fist around the bottom of the urine channel that is located at the base of the bladder. As we get older, that fist tends to tighten and cause problems.”

“In women, the pelvic floor muscles are not as strong as they used to be or the bladder as a muscle itself is having spasms.

“For both men and women there are many other things to explore, including how much and what you drink, a variety of medical conditions, such as diabetes and sleep apnea, certain medications you may be taking, or even your weight.

“And both men and women can have overactive bladders. The bladder is a muscle and can have spasms just as muscles do in other parts of the body, such as when you get a charlie horse in the calf. Except when a bladder spasms, it pushes urine out.

“Bladder spasms become much more common as we age. When the bladder spasms, you could have the strongest Kegel muscles in the world, but a spasm will push right past them. When people talk about the Kegel muscle, it’s really referring to a group of muscles that make up the pelvic floor. To find out where they are located, try to stop urinating mid-stream. If you can stop, then you’re tightening the right muscles. If your stream keeps bouncing up and down, you are doing it wrong as you haven’t found the right muscles yet.”

(In the next article, we’ll discuss exercising those muscles in more detail.)

“In determining the cause of the spasms we look at a few things. First, make sure that there is not an infection or blood in the urine which may signal something more concerning in the urinary tract. Second, we make sure the bladder is in good position and the tissues and muscles that support it are healthy. And third, what other things in the diet or behavior may be contributing?

“After ruling out those possibilities, we then look at a three-tiered set of options to control the spasms. If one doesn’t work, or doesn’t appeal to the patient, we can go to the next option.”

Next issue: Options to control our bladder