Latchkey incontinence: everything you need to know about the brain-bladder connection

Latchkey incontinence is a form of urinary urge incontinence characterised by the sudden need to empty your bladder when you put the key in your front door.

Picture this: you're on your way home from work or catching up with friends and everything is fine... until you get to your front door. You fumble around in your bag for your keys and as soon as you open the door you have to drop everything on the floor and run to the bathroom just to make it in time.

If you can relate to this scenario, keep reading to learn everything you need to know about latchkey incontinence and the brain-bladder connection.

The brain-bladder connection

Your kidneys are constantly filtering blood and producing urine, which means your bladder is always slowly filling up. As your bladder fills up and reaches 200ml, nerves send messages to your spinal cord that pressure is building. Those signals travel to the brain, which then decides whether to hold it in or not.

If it’s not a great time to pee — maybe you’re in the middle of a meeting, or there are no toilets around — your brain instructs your detrusor muscles to stretch in order to hold in more liquid and your urethral sphincters and pelvic floor muscles to squeeze to prevent any unwanted leaks.

If it’s an appropriate time to go, your brain lets you know and you feel the urge to go. Once you're in the loo, your brain tells the bladder to contract and the pelvic floor and sphincter muscles relax. You open your urethra and pee. Sweet release!

Usually, your brain and bladder work together in harmony. In urge incontinence, the signals between your bladder, nerves and brain get mixed up and the bladder contracts when it shouldn't. This leads to involuntary leaks and that sudden need-to-go-or-I’ll-wet-myself feeling.

Oftentimes this can be triggered by lifestyle factors like smoking or drinking alcohol, physical factors like menopause and childbirth, or behavioural factors like holding your pee in or going “just in case”.

Causes of latchkey incontinence

Latchkey incontinence is a by-product of urge incontinence, which can happen due to several reasons.

Some causes of urge incontinence include:

• Constipation, which can put unwanted pressure on your bladder.

• Chronic urinary tract infections (UTIs).

• Some neurological conditions like Parkinson’s disease and MS, which can damage the nerves of the bladder.

• Medications such as angiotensin-converting enzyme (ACE) inhibitors, diuretics, some antidepressants, hormone replacement therapy (HRT) and sedatives.

• Drinking too much alcohol or caffeine, or not drinking enough water. Both of these factors can irritate the bladder and cause symptoms of overactivity.

• Pregnancy and childbirth.

• Menopause.

• A severe bladder injury.

Latchkey incontinence happens in people with poor bladder control and is triggered by certain habits, like always peeing as soon as you get home (even if you don’t need to go). Over time, these habits override the signals between your bladder and brain, becoming triggers.

But despite the name, it's not just opening your front door that can trigger the urge to go to the bathroom. Some people experience a similar urgency when they hear running water, like when washing their hands or taking a warm shower.

How to treat latchkey incontinence

If you’re struggling with latchkey incontinence, you’ll be glad to hear that there are some things you can do to tackle the problem.

• Break the pattern. Instead of going to the bathroom as soon as you get home, get into the habit of holding it in and waiting a few minutes. Gradually increase the time, this will allow your bladder to hold in more liquid before needing to empty. You can keep yourself distracted to help ignore the urge by making dinner, doing some chores, watching TV, etc.

• Try bladder training. Bladder training is a form of behaviour therapy done with the help of a specially trained expert used to treat incontinence.

• Strengthen your pelvic floor muscles. Pelvic floor exercises like Kegels can be done at home, without the supervision of a doctor. They help strengthen the pelvic floor and improve bladder function.

• Practice good bathroom etiquette. Check out Jude’s do’s and don’ts of peeing!

• Try a supplement. Medications can help with your bladder condition but before you go down that route, you might want to try a natural supplement first. The pumpkin seed and soy germ extract in Jude's Bladder Strength Supplements work together to improve your bladder and pelvic muscle tone, and reduce frequency by up to 79%.

• Stay hydrated. Drinking enough water throughout the day and cutting back on bladder irritants like caffeine and alcohol can reduce your risk of UTIs and bladder irritation, which can make urge incontinence worse.

• Medical solutions. If lifestyle changes and bladder training aren’t enough, your doctor may recommend certain medications or surgery to treat urge incontinence.

Poor bladder health shouldn’t be a “normal” part of ageing or childbirth — that’s why we created the Bladder Care Handbook: our guide to life’s trickly moments. Download your free copy for expert tips on how to look after your bladder.