Urinary Incontinence - the basics

Women who experience leakage from their bladders or have the “got to go” feeling at inconvenient times are not alone. The problem, though embarrassing for some, is more common – and treatable – than many women realize.

A recent research study, which analyzed nine years of data from 3,000 women ages 42-64, found that 68 percent of this group experienced the problem at least once a month. In fact, more Americans suffer from urinary incontinence than from diabetes and hypertension.

Women over 40 commonly suffer from two types of urinary incontinence: stress incontinence and urge incontinence.

Stress incontinence is characterized by involuntary leakage during or after an event, such as coughing, laughing, sneezing, or exercise. It usually occurs because of a weakness in pelvic floor muscles or the stretching out of the support tissues around the urethra.

Urge incontinence involves the muscles around the bladder, which puts pressure on the organ at inconvenient times, or with too much frequency. Though the cause of the latter type is unclear, it has been closely tied to diabetes, and other medical problems.

Concerns about incontinence cause some women to make negative lifestyle changes, such as not exercising for fear of leakage, not attending social events due to worries about smell, or limiting travel due to the need for regular bathroom access. Many do not know there are treatment options available.

I often find that many patients are embarrassed to discuss their urinary incontinence. Some think it’s such a normal consequence of having children and getting older that it’s something they have to live with.

Urogynecology, or the study of women’s incontinence and other pelvic issues, recently became board certified and is one of medicine’s newest subspecialties. A urogynecologist is the only type of doctor that has specialized training to treat urinary incontinence in many non-surgical, and minimally invasive ways.

Sometimes patients are taught how to do specialized exercises to strengthen their pelvic floor muscles. Others are prescribed products similar to vaginal diaphragms intended to prevent leakage. Studies have also shown that weight loss decreases the frequency of stress incontinence.

If conservative measures are not successful, then sometimes a form of acupuncture can be performed to correct urge incontinence. Another option may be to inject Botox into the bladder. These technique have a success rate of greater than 80%, which oftentimes persists for more than 1 year. Best of all is that both of these therapies are generally covered by major insurers.

One of the more recent advances in the treatment of stress urinary incontinence is the development of the suburethral sling. Since the early 1990’s, over 3 million slings have been performed worldwide, and have achieved a remarkable safety record while reaching a success rate of about 90%. Furthermore, the procedure only takes about 10-15 minutes to perform, and most people can be back at work within 2 days.

Body changes are a natural part of being a woman, but bladder leaks shouldn’t hold anyone back from the activities they love. Women who may be experiencing bladder leaks should talk to their doctors about their symptoms and how to manage leaks with the right protection.

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