Rushing to the Bathroom? A Little Weight Loss May Help

Have you ever lost a few drops of urine while coughing or running, or didn't quite make it to the bathroom in time? You may be one of the millions of American women who suffer from urinary incontinence, an involuntary loss of urine that while not a serious health problem, can be very embarrassing.

While women experience urinary incontinence twice as often as men and it becomes more prevalent with age, the condition is very treatable once diagnosed. According to Heather Wargo, MD, a urologist on staff at Lourdes Medical Center of Burlington County, there are multiple possible reasons for urinary incontinence, but two main types: 

  • Stress incontinence occurs when you sneeze, cough, laugh, jog or do other things that put pressure on your bladder. It is the most common type of bladder control problem in women.
  • Urge incontinence happens when you have a strong need to urinate but can't get to the bathroom in time. This can occur even when the bladder is holding just a small amount of urine, and without warning. Overactive bladder is a kind of urge incontinence, but not everyone with overactive bladder leaks urine.

Tracing Stress Incontinence
Pregnancy, childbirth, menopause, surgery and weight gain are among the physical changes that can cause stress incontinence.

"If you have good pelvic floor support, the elevated abdominal pressures that occur when you perform activities such as coughing and heavy lifting are exerted equally on your bladder and your urethra. However, if the pelvic floor muscles, vagina and ligaments weaken, they can no longer support your bladder and urethra. The elevated pressures are no longer exerted equally," Dr. Wargo explained. "The urethral sphincter muscles may not be strong enough to overcome the rise in pressure and keep the urethra squeezed tightly shut, allowing urine to leak during times of physical stress. In some people, the urethral sphincter itself is deficient and is no longer able to stay tightly closed."

Stress incontinence also can worsen during low estrogen states, such as during menopause or even the week before menstruation, as reduced estrogen levels may lead to lower muscular pressure around the urethra.

Relieving Symptoms
A new study in Obstetrics & Gynecology shows that shedding just a little weight may greatly reduce incontinence symptoms.

Researchers studied the effects of weight change in 338 overweight or obese women with urinary incontinence. All had a body mass index between 25 and 50 and were provided information on healthy lifestyles or enrolled in a weight-loss program.

After 18 months, the results showed major changes for women who lost just 5 to 10 percent of their initial body weight. These women were up to four times more likely than women who gained weight to report significant improvement in their symptoms. Many of them reduced incontinence episodes each week by 70 percent or more. These results were true even among women who weighed the most and struggled with the most frequent symptoms.

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Other treatment options for urinary incontinence include:

  • Training yourself to use the bathroom at regularly timed intervals.
  • Kegel exercises to strengthen the pelvic floor muscles. These exercises help many people improve bladder control in several weeks.
  • Avoidance of caffeine, smoking, alcohol and other bladder irritants.
  • Medicines to block the nerve signals that cause frequent urination and urgency.
  • Stimulation of nerves to the bladder leaving the spine (neuromodulation). While not for everyone, this therapy has proven effective for some who have not responded to behavioral treatments and medications.

There are two types of surgical options for stress urinary incontinence:

  • Injection of collagen or some other material into the peri-urethral tissues. This is called urethral bulking and works to prevent urine from leaking out of the urethra by narrowing the channel.
  • Surgery to support the urethra, such as placing a urethral sling in the space between the urethra and vagina. The sling may be composed of synthetic mesh material, the patient's own tissues or tissue from a donor. "The sling resembles a hammock and provides the correct amount of support for the urethra," Dr. Wargo said.

"Women should not have to live with urinary incontinence," she added. "There are many treatment options available. Speak with your physician to find the right one."

Last reviewed: November 2010