Some of life’s greatest pleasures – laughing, dancing, exercising – can cause fear and embarrassment in women with urinary incontinence.
An estimated 12 million adults in the U.S. have urinary incontinence (UI), the involuntary leakage of urine. Women experience UI twice as often as men. Pregnancy and childbirth, menopause and the structure of the female urinary tract account for this difference. And while UI is most common in women over 50, it also affects younger people, especially women who have just given birth.
Women’s Care physician Melissa Edwards, MD, is a gynecologist with specialized training in treating female incontinence and pelvic prolapse. She says that the good news is that a majority of women can overcome UI through physical therapy, lifestyle modifications, medication, and, in some cases, surgery.
According to Dr. Edwards, there are two major types of urinary incontinence:
Stress incontinence is most often caused by a sudden increase in pressure in the pelvis muscles during coughing, laughing, lifting or exercise.
Dr. Edwards notes that contrary to popular belief, stress incontinence is not a normal part of aging. Instead, it is often a delayed result of pregnancy. “It’s like a run in your pantyhose,” she explains. “At the beginning of the day it’s small and barely noticeable, but by the end of the day is has run all the way up your thigh.” Similarly, small injuries to the pelvic ligaments during childbirth become larger over time, causing significant symptoms to occur later in life. Other causes of stress incontinence include repetitive heavy lifting, straining from chronic constipation, smoking and natural differences in the strength of an individual woman’s connective tissue.
Some women will overcome stress incontinence with physical therapy. Your Women’s Care physician can refer you to a physical therapist who specializes in treating UI and other pelvic floor disorders. Physical therapy most often involves Kegel exercises, biofeedback techniques and use of vaginal weights. Physical therapy generally consists of weekly visits for six to eight weeks but requires an on-going home exercise routine to maintain the effects. Most insurance plans cover physical therapy for UI.
For patients who don’t improve with physical therapy, surgery may be an option. Dr. Edwards notes that surgical options for stress incontinence have improved dramatically in recent years and, in some cases, can now be done on an outpatient basis. The procedure involves placing a piece of mesh under the urethra, or neck of the bladder, to support it. Patients go home the same day, usually without a catheter, and return to light work duties in one or two weeks.
Urge incontinence occurs when the need to urinate comes on too fast — before you can get to a toilet. It can result in the bladder emptying during sleep, when thinking about urinating, or when you touch water or hear it running. Certain fluids and medications such as coffee and diuretics, or emotional states such as anxiety, can worsen the condition.
Urge incontinence is caused by bladder muscles that contract inappropriately, regardless of the amount of urine in the bladder. In many cases, urge incontinence can be treated with lifestyle changes including reducing caffeine and managing fluid intake. In other cases, medications may be used to prevent the involuntary contraction of the bladder and improve bladder function.
If you experience the embarrassment or inconvenience of urinary incontinence, don’t suffer in silence. Be sure to talk with your Women’s Care physician about treatment options that will get you dancing and laughing confidently again!